HomeMy WebLinkAboutBuilding Permit #658 - Exception 5/6/2008 (2)Permit NO: � �1/
Date Issued: 5' G /a e
BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Date Received
6V "G-..
rO\
c
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
New Building
One family
Addition
Two or more family
Industrial
Alteration
No. of units:
Commercial
Others:
Repair, replacement
Assessory Bldg
Demolition
Other
Septic
1=loodplai " 'Wetlands
Watersued Qstrict. .
Water/Seuuer
LltSCKIP I ION OF WORK TO BE PREFORMED:
--/�) /.�v,Lb A- 5%46k .5,11cD
Identification Please Type or Print Clearly)
OWNER: Name: Phone
Address:
ARCH ITECT/ENGINEER /�' J14 Phone:
Address:
Reg. No.
FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F.
Total Project Cost: $ 2,004� FEE: $ '
Check No.:perl� ' "� Receipt No.:
NOTE: Persons contracting with unregistered contractors do not have access guaranty fund
VA
(AN
1
z�
Z.
o
06
N
52
L0
w
IL
a (1)o
i
~
\
F
N
e
Z O
CD
~ O U
o
v
o
LL U)
O z
cn '
o.
o::
� N
o w' n
G O
U
EU;
Z N
o
J
Z
m
Q'
Qpm
Q
Q CO
0
�XM
wmN
Z N
MOD
wdm
A
Date .... (/ ....... ........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ......... (- /-,� 7,4
....................................................................................
has permission to perform ........ . ..... C-: ............ / ..........................
wiring in the building of ... ... ..... . ........
.................
I
at .... ......................................................................... , North Andover, M
...... ,e6
Fee..2.��.:: ......... Lic. No. ..... ............
ELhcrRICAL INSPEC`r-OR�
Check #
8 i 60
- VY/L/1 v� r�idSSacnusetts df cial Use
. ,r. Only
Department of FireNo
Services
Permit .
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checkeds':'
[Rev 1/n
UV
APPLICATION FOR PERMIT TO PERFORM EL (leave blank
All work to be perforated m accordance with the Massachusetts Elechica] Code ECTRICAL WORK
PLEASE PRINT W AT op TYPE ALL INFOR11� yyo. (M�), 527 CMR 12.00
City or Town of- NORTH ANDOVER Date:
By this application the undersigned gives notice of his or her
Location (Street & Number) I ' To the Inspector of Wires
mon to Perform the electrical. work described below.
Owner or Tenant — �f r•• 2 C L, I ,I 1=a. r -c,_ -_ t \
Owner's Address
Telephone No.
Is this permit in conjunction with a building permit?
Purpose of Building {��� Yes No (Check Appropriate BOY)
Existing Utility Authorization No __t 3 0013
Service Amps _ / _Volts
Overhead Undgrd 0 No. of Meters
New Service C.1� v
------- � Amps �Z�� Volts Overhead
Number of Feeders and Ampacity L� Uailgrd ❑ No. of Meters_
Location and Nature of Proposed.Electrical Work: (J
Y'\
No. of Recessed Luminaires
pNo.ofDryers
uminaire Outlets
uminaires
eceptacle Outlets
A
NO.witches
an;es
Y
aste Disposers
ishwashers
ryers
r -
Co letion of the
o, of Cert.-Susp. (Paddle) Fans
G. of Hot Tubs
�! INa. of Water
Heaters . KW a -
mming pool arnd e ED
of OR Bra-aers
of Gas BuLmers
of Air Cond.
Area Heating KW
•g Appliances KW
No. Hydromassage Bathtubs No�ofj�Otors
OTHER
Ballasts.
Total Hp
win table may be waived b the I
Na. of nrpecto,
TransformersKVA VA
Generators KVA
n. o mergency i —
Batte IInits
mg
F'RE ALARMS Na. of Zones
o, of election and
Initis Devices
No. of Alerting Devices
o. of On ed
Detection/Ale Devices
Local 0 ConnectioMunicipaln ❑ Other.
Security Systems:
No. of Devices or E aivalent
Data Wiring:
No. of Devices or E aivalent
Telecommunications
No. of Devices or Ea�f m.
Estimated Value of Electrical Work typ mach additional detail if desired, or required by the Inspector of Wires.
Work to Start (When required by municipal policy
1 I l o �f I=s ections to be requested in accordance with MEC Rule 1 Q, and upon completion
INSURANCE COVERAGE: Unless waived by the owner no
the licensee provides proof of liabili Pmt for the performance of electrical work may issue unless
undersigned certifies that such coverage, a rnclud%ag "completed operation" coverage or its substantial equivalent. The
m force, and has exhibited proof of same to the
CHECK ONE: INSURANCE p� OTIC permit issuing office.
I certify, under the pains and enalges o (Specify )
F RM NAME: p fPm7ury, that the in
on this application is true and complete
iALf my !c nc
Licensee: As'" LIC. NO.: ao� q
(If applicable, 7. SiMature
1-0
Address: �( hemp[ in he license �mb ne.) LIC. NO.: t,/ p l"o
��?_ �( Bus. Tel. No.:
*Per M.G.L c. 147, s. 57-61, security work require epartatent of Public Safety S License: Alt TeL No.:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have 1ihe liability
required by law. B Lic. No.
Owner/Agent Y signature below, I hereby waive this requirement I am the (check one) insurance normally
Signature ❑ owners agent.
Telephone No. PERMj� FEE: $ S ,5
•
•1
!.
.Ar
;:,
•
4
�
r t
Sob Site Expirafion Date:
Ad&ms,.
Attach a Dopy Of -the .workers' cone C�/ship:
d Compensation policy deciaratioo page (showing the poli number and expiration date},
Failure to secure eoverege as requited under Section 25A of
fine up to $1,50Q:00 and/or one-year imprisonment, MGL C. 152 can lead 6 the imposition of=.'minal
of up to $250.00 a prisonment, as well as civil penalties in the form of a STOP WC) p petusities of a
of sEi * �i�-tire violator. Be advised that a copy of this statement maybe forty !DER and a fine
gations of the DIA for instrmee, coverage verification. arded to the Office of
J ao hereby ca�fi y under the pains orad
°fPellur9 tlsat eke information pranided above is
true and coned,
Of, frciol rose only, do not write tri .this ore¢, co let
nr ed by city or town gficw
City or Town:
Issuing ,4utho�' (•rcie ee): ` cPerndt/License #
�
1. Berard of HeslEh 2 Suikougo
Other DePa�ent 3. CitylTov n Clerk 4. Electrical Inspector 5.
b Plumbiug Inspector
Contact Person:
Phone #:
The Commanweaft of Marsachasel&
1�'
Department of Adustrial Accideft
w' e of Znvesvgadoirs
iltii i
ti. a r
r�
-
600 Washington Street
Boston ,MA 02111 .
Workers' Compensation
A Iicaat Information
Iase�rance w� MaMffov/da .
Arlavit: Builders/Contractors/Eieatriciaas/Pfambers
Please Print Le'biv
Name fBusiness/Org"i�ari4ndividnalj;
Address.
P01,f 9,C
Ci tyi.staterzip:
Phone #:..
Are you an employer? Check the
appropriaEe-hoz
I. ❑ 1- employer with
'
4. ❑ I Sat a general Type -of project (reQuiredj:
ioyees (foil 8etor r
2•' I arrt:asole proprietonor
contractor and I
* have hired the st&.onlracto� 6•. ❑New construction
pwtner.
partner-
ship and have no oY emP 1 ees
I&Md on the attached sheet i 7. ❑ Remodeling
These Su&Contractots have
working forme in any capecapacity,work
[No workers' comp, insurance
g• Q Oamoiition
:5.❑ .wire em, comp. insurance.. g, $w7di a
are $corporation end ❑ ng 'addition
.required.]
3• ❑ I ain a homeowner � nit work
ifs .-..
o�� have exercised their 10•❑ Electrical repairs or additions
right of exemption
myself [No•work�' cant p
instuw=
� pa MGL I 1-[Q Piwnijingrepaits,oraddiiions
c• �Z, § 1(4),'and we have
t
d j -
no
.ompioyees, [No workers' 12 ❑ Roof repairs
• �P• inaurancx required]: 13 ❑ Otitcr
fio appiicmrsi runt dsecks boo # I mum also fill otrt the section below showing their workers' iso
sobthi
t liomeowaers who udavit -Wj=ts
aff mpmssatioo
g they am doing all wot}t policy infotrnation.
' b.;(
�CAntractots that rhealc this box mustattaehed an acldifios:sl shertslww' awd User hce•omaide contractors QW s
trrg theacme of the sub-cootrecm� ubmit a new affidavit indioatisg atWL
info — mpi0ye, aw.esProvi mnadam g:warkera' compensafian iasuraaee or their workers comp. policy inbrmatioa.
mJ' �e�: Below
Insurance Company Name:
. rs.tke poffcy and
Me
Policy # or Self --ins. Lie. #:
Sob Site Expirafion Date:
Ad&ms,.
Attach a Dopy Of -the .workers' cone C�/ship:
d Compensation policy deciaratioo page (showing the poli number and expiration date},
Failure to secure eoverege as requited under Section 25A of
fine up to $1,50Q:00 and/or one-year imprisonment, MGL C. 152 can lead 6 the imposition of=.'minal
of up to $250.00 a prisonment, as well as civil penalties in the form of a STOP WC) p petusities of a
of sEi * �i�-tire violator. Be advised that a copy of this statement maybe forty !DER and a fine
gations of the DIA for instrmee, coverage verification. arded to the Office of
J ao hereby ca�fi y under the pains orad
°fPellur9 tlsat eke information pranided above is
true and coned,
Of, frciol rose only, do not write tri .this ore¢, co let
nr ed by city or town gficw
City or Town:
Issuing ,4utho�' (•rcie ee): ` cPerndt/License #
�
1. Berard of HeslEh 2 Suikougo
Other DePa�ent 3. CitylTov n Clerk 4. Electrical Inspector 5.
b Plumbiug Inspector
Contact Person:
Phone #:
Information. a ind 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,
exprr-ss or implied,. oral or writtrn."
An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more
ofthe'foregoing engaged in a joint enberprise, and includireg the legal representatives of a dec cased employer, bribe
receiver ortrustee -of an individual; partnership, associatiotr or other legal wtity, employing empicyees. '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* w6flk on such dweitinghouse
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, J25C(6) also states that "every state o*s- local licensing agency shall withhold the issuance or
renewal (if a Iicense or permit to operate a busmeas or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence.or compliance with the insurance coverage required"
Additionally, MOL chapter 152, §25C(7) states "Neither the commenweabEh nur any of its -politica] subdivisions shall
enter inu 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 compirm-tely, by checking the boxes that apply to your situation and, if
necessary, supply sub -contractors) name(sL address(es) and phone number(s) along with their c artificate(s)' of
insurance. Limited Liability Companies -(LLC) or Limited Liability Partnerships (LLP) with no employees other than the
members or partners, are not mquirad to cavy workers' Mmnpawation insurance. if an LLC. or LLP does have
empioyees, a .policy is required. Be advised that this afficiavit.may be submitted to the went of Industrial
Accidents for confirmation of insurance coverage.. Also 'be sure to sign and trate the affidavit The affidavit should
be muzrrred to the city, or town that the application for the peimit or license is being requested, not the Department of
Industrial Accidents. Should you have any questions regaLT-ding the law or if you.are required to obtain a workers'
compensation policy,.please-call the Department at the nuo ribm listed below. Self -inured companies should enteriheir
self-instaan=-jicanse number on the, appropriateiir�.
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 due event the Office of Investigations has to contact you regarding the applicant t
Please be sure to fill in the permit/license number which vaijI be used as a reference number.. in addition, an applicant
the. must submit multiple permit/iicense applications in arty given year, need only submit one'affidavit indicating -current
policy'infonnation (if necessary) and under "Job Site Adds-ew" the applicant should write "all locations in (city or
town)." A copy ofibe affidavit that has been officially stamped or marked by the city or town may be provided to the
i. .
applicant as proof that a valid affidavit is on file for forum 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
(.e..a dog license of permit to bum leaves etc.) said person is NOT required to -.complete this affidavit.
The Office of Investigations would It - to: thank you in advance for your cooperation and should you have any questions,
please do not. hesitate to give us a call.
The Depamnant's address, telephone and fax number.
The Commonwm lth of Massachusetts
Departrneu of 1ndnst W Accidents
Office of Inveakations
600 Washington Street
Boston; MA €1211'1
TeL # 617-7274900 rxt 406 or 1-977-MASSAFE
Revised 5-26-05 Fax m 617-727-774
wwwMem.govldia
/�►ORTl1 0
O
' O
0 �
BUILDING DEPARTMENT
Community Development Division
MEMORANDUM
Patricia Lambert
125 Windkist Farm Road
North Andover, MA 01845
RE: BUILDING PERMIT FOR INDOOR RIDING ARENA
Dear Ms. Lambert:
Your application for a building permit to construct an 8,382 square foot indoor riding facility is
denied on the following grounds:
You have not submitted a report from a structural engineer as required by the State
Building Code. See 780 CMR 116.0.
2. You have not submitted a geotechnical report from a licensed engineer in order to address
the foundation and soil conditions in which the foundation was erected, as required by the
State Building Code. See 780 CMR 116.0.
3. You do not have the required certification for a summer camp for children as required by
Table 106 of 780 CMR.
4. The North Andover Fire Chief has determined that the structure is required to have
sprinklers, and a fire detection and alarm notification system to notify occupants of a fire in the
structure.
You may appeal my determination as to the Building Code to the State Building Code Appeals
Board (see G.L. ch. 143, §93 and § 100), One Ashburton Place, Room 1301, Boston, MA 02108.
You are not required to file for a site plan special permit under Section 8.3.2(a) of the North
Andover Zoning Bylaw.
Very truly yours,
Gerald Brown,
Inspector of Buildings
cc: Curt Bellavance
Mark Rees
Attorney Thomas Urbelis
1600 Osgood Street, North Andover, Massachusetts 01845
Phone 978.688.9545 Fax 978.688.9541 Web www.towaofnorthondover.com