HomeMy WebLinkAboutUntitled Department of Fire Services
Office of the State Fire Marshal
P. O. Box 1025, State Road,Stow,MA 01775
CERTIFICATE OF REGISTRATION
North Andover April 30, 2021
(City or Town) (Date)
NOTE: Complete top and bottom of form and forward both sections and fee to local Licensing Authority(City or Town Clerk).
DO NOT RETURN FORM TO THE DEPARTMENT OF FIRE SERVICES.
In accordance with the provisions of Chapter 148, Section 13, of the General Laws,the undersigned hereby certifies that:
(TITLE HOLDER): AIMCO/TTA MS 235
(ADDRESS): 3 Galleria Tower
13155 Noel Rd Ste 100 LB 235
Dallas TX 75240
is the holder of the license granted (Date): April 26, 2021 for the lawful use of the building(s) or other
structure(s) situated or to be situated at(ADDRESS: 1 Royal Crest Drive
NORTH ANDOVER, MA 01845
(City or Town)
as related to the KEEPING, STORAGE, MANUFACTURE OR SALE OF FLAMMABLES OR EXPLOSIVES.
NOTE: This certificate of registration must be signed by the holder of the license if said license was granted prior to July 1,1936,
Otherwise by the owner or occupant of the land licensed. 15,000 gals Propane
Received ...........................2021......... ...............................................................
(Signature)
By ....................................... ......................................................
(Official Title) (Clerk) (State whether owner,occupant or holder)
......................................................
TOWN OF NORTH ANDOVER
LICENSING COMMISSION
120 MAIN STREET
NORTH ANDOVER, MASSACHUSETTS 01845
Rosemary Connelly Smedile, Chair *` 11 `'�-w•
Chris Nobile TEL. (978)688-9510
Richard Vaillancourt FAX(978)688-9557
Laura Bates
Janice Phillips
MEMORANDUM
TO: Rosemary Smedile Chairman, Licensing Commission
Members of the Select Board
Melissa Murphy-Rodrigues Town Manager
FROM: Patricia Sifferlen, Clerk
DATE: April 26, 2021
SUBJECT: Above Ground Storage Tank
Attached please find the application from AIMCO/TTA for a license to store 15,000 Gallons of
Propane on site 28-500 WG gallons above ground tanks and 1-1000 Gallon above ground tank
located at 1 Royal Crest Drive. Advertised in the Eagle Tribune and abutters duly notified.
Included are the recommendations from the Planning Department, Building Inspector, Police
Department and Fire Department.
If you have any questions or concerns please don't hesitate to contact me.
Thank you.
DocuSign Envelope ID:8896FE97-F8E5-460A-B285-CB4B7BACC979
n�l� oon.nlo�crnncc���i a ' '. Lrtuucrl.�eCls
GIS Coordinates
ol' NORTH ANDOVER 42.671540
> LAT.
Application For License -71.11 LONG..
Massachusetts General Law, Chapter 148 §13
FP-002A _.._
Liccmcc Number
(Rev. 1.2018)
14 New License O Amended License
Application is hereby made in accordance with the provisions of Chapter 148 of the General Laws of Massachusetts for a license to
store flammables,combustibles or explosives on land in buildings or structures herein described.
Location of Land: 1 Royal Crest Drive/Property Account: M_231170_935863/Parcel ID: 025.0-0066-0000.0
NusilLv Street and Asscssm'b Map and Parcel to
Attach a plot plan of the property indicating the location of property lines and all buildings or structures.
Owner of Land: AIMCO/TTA MS 235
Address of Land Owner:Three Galleria Tower, 13155 Noel RD STE 100 LB 235, Dallas, TX, 75240-5090
Use and Occupancy of Buildings and Structures: Residential Living Community /Apartments
If this is an application for amendment of an existing license,indicate date of original license and any subsequent amendments
This applkabon is to brag property upto a—awt licensing standards.Currant tanks are being upgradad.No beans*was required at tune of the isvllal construction.
Attach a copy of she CWYCAt lieeale
Flammable and Combustible Liquids, Flammable Gases and Solids
Complete this secliun for the slorage ufJlainmable and combustible liquids, solids, and gases,-see 527 C11? 1.00 Table 1.12.8.50;
tllach additional pages if needed AU tanks and containers are considered Jir/1 for the purposes of licensing and permilling.
PRODUCT NAME CLASS MAXIMUM UNITS CONTAINER
QUANTITY gal„Ibs, UST,AST,IBC,
cubic feet drums
Total quantity of all flammable liquids to be stored: -0-
Total quantity of all combustible liquids to be stored: -0-
Total quantity of all flammable gases to be stored: -0-
Total quantity of all flammable solids to be stored: -0-
DocuSign Envelope ID:8896FE97-F8E5-460A-B285-CB4B7BACC979
LP-gas (Complete this secr)onfor the storage of 1.1'-gas or propcure)
Indicate the maximum quantity of LP-gas to be stoned and the sizes and capacities of all storage containers.
(See 527('All? 1.00 lcrble 1,12.8.50)
Maximum quantity(in gallons)of LP-gas to be stored in aboveground containers: 15,000 gallons
List sizes and capacities of all aboveground containers used for storage:
28-500 wg above ground tanks, 1 - 1,000 wg above ground tank
Maximum quantity(in gallons)of LP-gas to be stored in underground containers: ZERO(0)
List sizes and capacities of all underground containers used for storage: Existing UG tanks are being removed
'Note:These above ground tanks are replacing existing UG tanks installed when the project was constructed.
Total aggregate quantity of all LP-gas to be stored: 15,000 gallons
Fireworks (Complete this section fur rite storage q1*ireworks)
Indicate classes of fireworks to be stored and maximum quantity of each class. (See 527 CA4R 1.00 Table 1.12.8.50)
•:• Maximum amount(in pounds)of Class 1.3G: -o- Type/class of magazine used for storage:
Maximum amount(in pounds)of Class 1.4G:_-0- Type/class of magazine used for storage: -
•:• Maximum amount(in pounds)of Class IA: -0- Type/class of magazine used for storage:
Total aggregate quantity of all classes of fireworks to be stored: -0-
Explosives (Complete this section for the storage of explosives)
Indicate classes of explosive to be stored and maximunn quantity of each class. (See 527 CAM 1.00 Table 1.12.8.50)
❖ Maximum amount(in pounds)of Class 1.1: -0- Number of magazines used for storage: -
❖ Maximum amount(in pounds)of Class 1.2: -0- Number of magazines used for stora.ge: -
Maximum amount(in pounds)of Class 1.3: .0- Number of magazines used for storage:
❖ Maximum amount(in pounds)of Class IA: ° Number of magazines used for stora-e: -
Maximum amount(in pounds)of Class 1.5: ° Number of magazines used for storage: -
Maximurn amount(in pounds)of Class 1.6: 0 Number of magazines used for storage:
Martin Sprang
!, hereby attest that I ant authorized to make this application. I acknowledge thatthe
information contained herein is accurate and complete to the best of my knowledge and belief. I acknowledge that all
materials stored pursuant to any license granted hereunder must be stored or kept in accordance with all applicable
laws,codes, rifles and regulations. including but not limited to Massachusetts Chapter 148,and the Massachusetts Fire
Code(527 CMR 1.00). 1 further acknowledge that the storage of any material specified in any license granted
hereunder may not exceed the maximum quantity specified by the license.
Signature Date 2/18/2021 Name Martin Sprang
Fire Department Ue Only
1, ,Head of the NORTH ANDOVER _-Fire Department endorse this application with my
❑ Approval ❑ Disapproval
Signature of Heud arUte Fie Department Date
Recommendations:
FP-002A(Rev. 1.2018) Page 2
GIS Coordinates
a/' NORTH ANDOVER 42.671540
LAT.
-71,119300
LONG.
Certificate of Registration
FP-005 License Number
(Rev. 1.2018) Massachusetts General Law, Chapter 148 §13
In accordance with the provisions of Massachusetts General Law,Chapter 148 §13,the undersigned hereby certifies that:
Person,partnership,corporation or other entity: AIMCOTTA/TTA MS 235
Name of l..icetse Holder
Three Galleria Tower, 13155 Noel RD STE 100 LB 235, Dallas, TX, 75240-5090
Business Address of License Holder
Is the holder of a license Granted on , and subsequently amended on
For the lawful use of buildings and structures located or to be located at:
1 Royal Crest Drive/ Property Account: M_231170_935863/Parcel ID: 025.0-0066-0000.0
Number,Street and Assessor's tilap and Parcel ID
As relates to the keeping,storage,manufacture,or sale of flammables,combustibles,or explosives.
Signature or license Holder or Agent Date Printed Name
All materials must be stored in accordance with the provisions of Massachusetts General Law, Chapter 148,
the Massachusetts Fire Code(527 CMR), and all other applicable laws and regulations,including the terms and
conditions of the subject license. Quantities stored may not exceed the maximum quantityspecified by the license.
REGISTRATION
This is to certify that the within named license holder has in accordance with the provisions of Massachusetts
General Law, Chapter 148 §13 filed with me, a certificate of registration setting forth that the above named
entity is the holder of license as relates to the keeping, storage, manufacture, or sale of flammables,
combustibles, or explosives at the above described location.
Signature of OtTKiai Title Date
THIS REGISTRATION AND THE LICENSE MUST BE CONSPICUOUSLY POSTED ON THE LAND
FOR WHICH IT IS GRANTED.
The Commonwealth of Massachusetts
91V
�- Department of IndustrialAccidents
-� Office of'Investigations
}= Lafayette City Center
2 Avenue de Lafayette, Boston, MA 02111-1750
www.mas&gov/dia
Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Indivi(tual): Eastern Propane & Oil
Address: 131 Water St
City/State/Zip: Danvers, MA 01923 Phone #:800-322-6628
Are you an employer? Check the appropriate box:
Type of project(required):
1.0 I am a employer with ' 50 4. ❑ I am a general contractor and I
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 sheet. 7. ❑ Remodeling
shipand have no employees These sub-contractors have
8. ❑ Demolition
working for me in any capacity. employees and have workers'
insurance.♦ ❑ Building addition
corn
[No workers' comp. insurance P•
required.] 5. ❑ We are a corporation and its 10.7 Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 1 1.❑ Plumbing repairs or additions
myself. [No workers' comp, right of exemption per MGL 12.0 Roof repairs
insurance required.] { c. 152, §1(4),and we have no
employees. [No workers' 13.❑■ Other Propane Gas Fitting
comp, insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
-Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp,policy number.
1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: Liberty Insurance Corporation
Policy#or Self-ins. Lic. #: WC26454358060120 Expiration Date: 06/0 1/2021
Job Site Address: 1 & 28 Royal Crest Drive City/State/Zip: N. Andover, MA 01845
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct
Jim Blake Digitally signed by Jim Blake
Sienature: Dale:2021.03,19 11:02:06-04'00' Date 3/18/2021
Phone#: 978-750-6500
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License #
Issuing Authority(check one):
1❑Board of Health 20 Building Department 30City/Town Clerk 4.11 Electrical Inspector 50Plumbing
Inspector 6.1710ther
Contact Person: Phone#:
Abutter to Abutter( X ) Building Dept. ( ) Conservation ( ) Zoning ( )
TOWN OF NORTH ANDOVER
DIRECT ABUTTERS
REQUIREMENT. MGL 40A, Section 11 states in part"Parties in Interest as used in this chapter shall mea
abutters,owners of land directly opposite on any public or private way,and abutters to
property line of the petitioner as they appear on the most recent applicable
tax list, not withstanding that the land of any such owner is located in another city or toH
board of the city or town,and the planning board of every abutting city or town."
Subject Property:
MAP PARCEL Name Address
25 35&66 AIMCO/TTA Three Galleria Tower, 13155 Noel Road,Ste S
Abutters Properties Location: Royal Crest Apartments,Salem Turnpike,Nc
Map Parcel Name Address
25 1 North Andover Crossroads 861 Turnpike Street, North Andover,MA 01845
25 64 Pico Trust 401 Andover Street, North Andover,MA 01845
47 14 Robert Leyland,Jr 312 Turnpike Street, North Andover,MA 01845
47 15 Dianna Voong 318 Turnpike Street,North Andover, MA 01845
47 16 Benjamin Farnum 1370 Turnpike Street,North Andover, MA 0184!
47 31 Debroah Snow 1 Berkeley Road, North Andover,MA 01845
47 61 Thomas McSweeney 121 Berkeley Road,North Andover, MA 01845
47 62 David Naggar 113 Berkeley Road,North Andover, MA 01845
47 63&69 Jackobek Berkeley Trust 105 Berkeley Road,North Andover, MA 01845
47 64 Steven Gaul 97 Berkeley Road,North Andover, MA 01845
47 65 John Garth Gibbons FT 89 Berkeley Road, North Andover,MA 01845
47 66 Frank Ceraso 81 Berkeley Road, North Andover,MA 01845
47 67 Storey Realty Trust 73 Berkeley Road, North Andover,MA 01845
47 68 Susan Teberio 65 Berkeley Road, North Andover,MA 01845
47 70 Marilyn O'Brien 49 Berkeley Road, North Andover,MA 01845
47 71 Brenda Petrosino 41 Berkeley Road, North Andover,MA 01845
47 72 Concetta Velardocchia 33 Berkeley Road, North Andover,MA 01845
47 134 Town of North Andover 120 Main Street, North Andover, MA 01845
47 135 Alan&Cathy Breen Rev LT 25 Berkeley Road, North Andover,MA 01845
47 136 Gray Family Trust 49 Rosedale Avenue, North Andover,MA 0184,1
60 125 Joseph Musumeci 63 Quail Run Lane, North Andover,MA 01845
60 126 Joseph Robinson 71 Quail Run Lane,North Andover, MA 01845
60 127 David Dinapoli 83 Quail Run Lane, North Andover, MA 01845
60 128 Schruender Nominee Trust 91 Quail Run Lane,North Andover, MA 01845
60 146 Kenneth Heitzman 56 Monteriro Way, North Andover,MA 01845
60 147 Paul Powers 53 Monteriro Way, North Andover,MA 01845
98.0 6 S. K. Howe Realty Trust PO Box 254 North Andover, MA 01845
Abutter to Abutter List prepared and certified by Samuel G.Cheney,Jr.Assistant Assessor Town of North
Docu
SECURED
Certificate Of Completion
Envelope Id:8896FE97F8E5460AB285CB4B7BACC979 Status:Completed
Subject:Please DocuSign:Signature Required.pdf
Source Envelope:
Document Pages:5 Signatures:2 Envelope Originator:
Certificate Pages:5 Initials:0 Britney DeHond
AutoNav:Enabled 4582 S Ulster St
Envelopeld Stamping:Enabled Denver,CO 80237
Time Zone:(UTC-07:00)Mountain Time(US&Canada) Britney.Dehond@aimco.com
IP Address:209.66.121.226
Record Tracking
Status:Original Holder:Britney DeHond Location:DocuSign
2/18/2021 5:20:24 PM Britney.Dehond@aimco.com
Signer Events Signature Timestamp
Martin Sprang Doo Sia—db
P 9 L,�,_. Sent:2/18/2021 5:23:01 PM
Martin.Sprang@aircommunities.com cf i" Viewed:2/18/2021 5:24:57 PM
SecurityLevel:Email,Account Authentication 1-598iF 6FAA2D4C7
Signed:2/18/2021 5:25:21 PM
(None)
Signature Adoption:Drawn on Device
Using IP Address:205.220.219.113
Electronic Record and Signature Disclosure:
Accepted:2118/2021 5:24:57 PM
ID:48c8f 152-7e34-443d-a95f-eObdf53b9fb4
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Taran Franci COPIED Sent:2/18/2021 5:25:22 PM
Taran.Francis@aircommunities.com
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 2/18/2021 5:23:01 PM
Certified Delivered Security Checked 2/18/2021 5:24:57 PM
Signing Complete Security Checked 2/18/2021 5:25:21 PM
Completed Security Checked 2/18/2021 5:25:22 PM
Payment Events Status Timestamps
DocuSign Envelope ID:8896FE97-F8E5-460A-B285-CB4B7BACC979
Royal Crest Apartments - North Andover, MA
Parcel ID: 025.0-0066-0000.0 Parcel ID. 025.0-0035-0000.0
Property M 231170 935863 Property
— — M_231307_935492
Account:
Account:
Owner: AIMCO/TTA MS 235 Owner: AIMCO/TTA MS 235
Mailing THREE GALLERIA TOWER Mailing THREE GALLERIA TOWER
Address: 13155 NOEL RD STE 100 LB 235 Address: 13155 NOEL RD STE 100 LB 235
DALLAS TX 75240-5090 DALLAS TX 75240-5090
Property 1 ROYAL CREST DRIVE Property 28 ROYAL CREST DRIVE
address: 11 1 Address:
Card# Building# Tank Size: Card# Building# Tank Size:
1 Club House 1000 ag 1 Shop 500 ag
2 1 500 ag 2 29 500 ag
3 2 500 ag 3 30 500 ag
4 3 500 ag 4 31 500 ag
5 4 500 ag 5 32 500 ag
6 5 500 ag 6 33 500 ag
7 6 500 ag 7 34 500 ag
8 7 500 ag 8 35 500 ag
9 8 500 ag 9 36 500 ag
10 9 500 ag 10 37 500 ag
11 10 500 ag 11 38 500 ag
12 11 500 ag 12 39 500 ag
13 12 500 ag 13 40 500 ag
14 13 500 ag 14 41 500 ag
15 14 500 ag 15 42 500 ag
16 15 500 ag 16 43 500 ag
17 16 500 ag 17 44 500 ag
18 17 500 ag 18 45 500 ag
19 18 500 ag 19 46 500 ag
20 19 500 ag 20 47 1 500 ag
21 20 500 ag 21 48 500 ag
22 21 500 ag 22 49 500 ag
23 22 500 ag
24 23 500 ag
25 24 500 ag
26 25 500 ag
27 26 500 ag
28 27 1 500 ag
29 28 500ag
LicenseGallons 15,000 gallons License Gallons 11,000 gallons
ROYAL CREST CLUBHOUSE BASKETBALL MAINTENANCE
0 LEASING OFFICE TENNfS 2 BEDROOMS
ENTRAt4CE
ESTATES GARAGE 3 BEDROOMS
(NORTH ANDOVER) POOL CAVORT 00 PROPANE TANK
PJTrRNG GREEN GREEN HOUSE • PROPERTY LINE
17
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3/22/2021 Town of North Andover Mail-1 Royal Crest Drive
No OVER
Massachos ;b Patricia Sifferlen <psifferlen@northandoverma.gov>
1 Royal Crest Drive
Jean Enright<jenright@northandoverma.gov> Mon, Mar 22, 2021 at 12:08 PM
To: Patricia Sifferlen <psifferlen@northandoverma.gov>
Planning has no objections.
[Quoted text hidden]
Sincerely,
Jean Enright
Planning Director
Town of North Andover
120 Main Street
North Andover, MA 01845
Phone 978.688.9533
Fax 978.688.9542
Email: jenright@northandoverma.gov
Web: www.NorthAndoverMA.gov
V,,cid:image001.jpg@010EOF52.F68A5980
hftps://mail.google.com/mail/u/0?ik=bl 4a447b90&view=pt&search=all&permmsgid=msg-f%3A1694949022167291059&simpl=msg-f%3A16949490221... 1/1
3/24/2021 Town of North Andover Mail-1 Royal Crest Drive
�rsr�.
NORTq�CAN `0VER
Massachus` Patricia Sifferlen <psifferien@northandoverma.gov>
1` mac.
1 Royal Crest Drive
Daniel Lanen <dlanen@napd.us> Wed, Mar 24, 2021 at 9:59 AM
To: Patricia Sifferlen <psifferlen@northandoverma.gov>
The Police Department has no issues with this application.
On Mon, Mar 22, 2021 at 11:54 AM Patricia Sifferlen <psifferlen@northandoverma.gov>wrote:
[Quoted text hidden]
Lt. Daniel P. Lanen
North Andover Police Department
Operations Division Commander
E-mail: dlanen@napd.us
Phone: 978-242-1542
https://mail.google.com/mail/u/0?ik=b l 4a447b90&view=pt&search=all&permmsgid=msg-f%3Al 695122100381562922&simpl=msg-f%3A16951221003... 1/1
3/22/2021 Town of North Andover Mail-1 Royal Crest Drive
NORC Air1�OVER
�haysacnus@i5 w Patricia Sifferlen <psifferien@northandoverma.gov>
'! Royal Crest Drive --------- ------------------ ---------
Bob Kilcoyne<bkilcoyne@northandoverma.gov> Tue, Mar 23, 2021 at 5:18 PM
To: Patricia Sifferlen <psierlen@northandoverma.gov>
The Fire Department recommends favorably for removing existing Underground Propane Storage Tanks and replacing
them with Above Ground Propane Tanks.
Lt. Robert Kilcoyne
North Andover Fire Prevention
On Mon, Mar 22, 2021 at 11:55 AM Patricia Sifferlen <psifferlen@northandoverma.gov> wrote:
[Quoted text hidden]
y
- V9—imnl_mcn_f�/3A16950590732... 1/1
3/31/2021 Town of North Andover Mail-1 Royal Crest Drive
NOR � >p OVER Patricia Sifferlen <psifferien@northandoverma.gov>
Massachu . ,
1 Royal Crest Drive
Paul Hutchins <phutchins@northandoverma.gov> Wed, Mar 31, 2021 at 6:48 AM
To: Patricia Sifferlen <psierlen@northandoverma.gov>
No concerns with Building Department Must Follow NAFD guidelines
[Quoted text hidden]
https:Hmail.google.com/mail/u/0?ik=b l4a447b90&view=pt&search=all&permmsgid=msg-f%3Al 695744206280689445&simpl=msg-f%3Al 6957442062...