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Home My WebLink AboutBuilding Permit # 3/8/2016 BUILDING PERMIT o ,O RT a TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received RSSACHU`�E"� Date Issued: IMPORTANT:Applicant must complete all items on this page AP RCL IVB DISTRIG ig o Dts .- esu o TYPE OF IMPROVEMENT PROPOSED USE Residential % Non-Residential ew Building One family ❑Addition ❑Two or more family ❑Industrial o Alteration No.of units: ❑Commercial ❑Repair,replacement ❑Assessory Bldg Others: Demolition ❑Other p$c Well �[[loadplain U1(etLarttlsWftershecl Distract DESCRIPTION OF WORK TO BE PERFORMED: r,(,& 3 6ag ti°oowt_ a sfee-V cioe''no 71,96rro. '�7 Identification- Please Type or Print Clearly OWNER: Name: T�;�xoY .tac. Phone: 9�fB83 /G� Address: A9 D2. l�/®. .s�ov�2 Old ®oP9r5 e isoCons rg_c ianLicense _xp Date~` _. � 10-0 7 �No e�I� �ralre�-�tcese� /� ARCHITECT/ENGINEER eZ �W/7ell11,'4�r Phone: Address: Wn ee n1f1 /8/o 1 � Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER SF_ Total Project Cost:$ le-7�20 FEE:$ � ". Check No.: `f Receipt No.: 5 � NOTE: Persaus corxh ct' w th registered contractors do not have aecess to guaran fund S gnWtd're of eritlOwrier Signature"of ntracto ? , Plans Submitted❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ I,ypF6F SEWERAGE DISPOSA AvUIic Sewer L Swimming Pools i] Tanning/Massage/Body Art I Well ❑ (Tobacco Sales Food Paekaging!Sales ❑ Private(septic tank,etc. ❑ (Permanent Dumpster on Site L THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM PLANNING&DEVELOPMENT Reviewed On Signature Signature_ 6111 J COMMENTSU CONSERVATION Reviewed on—3 Si nature7 ,+ ( 77 Vu 1.51 COMMENTS �� -13 2 i l is �� E �` � (L D4b,-, HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments eongWater&Sewer Connection/signature&Date r` fy6` Drivewy'Permit �Ys'f 71) f/ In r "�� t' DPW Town Engineer:Signature: / v —� r . , Located 384 O'sgood Street FIRE DEPP�II�TMENT Temp Dempster on stye yes � ,; nn Lobated of 12<kMam Stieef Fire Department sagna�{ureldate , � � _ � � Town of) over No. . ......... 0 h ver,Mass, 0 ATED BOARD OF HEALTH Food/Kitchen PERMIT T ILD Septic System THIS CERTIFIES THAT.......- ................................. BUILDING INSPECTOR has permission to erect........--..............buildings on... All........."'.,................................. Foundation . /I Rough tobe occupied as......................... 71-/................................I....................—...................... Chimney provided that the person accepting this permit shall''fi every respect conform to the terms of the application Final on file in 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 Reg,Utations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service ................... Kw ............I.......... Final BUILDING INSPECTOR GASINSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det. r , m F ®W J ®® —__......... _............... ......_.__ Finish Grotle Nouse f 16=5 Front Elevation Colonial Drafting Alan Camo!/ r aua y o3 zore 978-902-0731 c() Kitchen Office Both Den Porch Dfning Family i Garage .................... L IJ ------ Colonial uKnt. 492 Drafting W14111 1,J47 0 M Both —A, Loft 44 Bearm I gco'rm 2 Colonial 521 Drafting House f6-6 Second Floor Plan Alan CorroH Feb—ry 03,2015 978-902-0131 Attic FM 0 IRI I Gh Gmd¢ House ,f# 16-6 Front Elevation � Drafting Dg Drafting AlonµGorrolf �, _ �, rebruory 03,2016 9]lj-9a2-01✓'l� - o Kitchen Office Both Den Porch n n - I Dining family Garage 4 Coloni-I II u��g so-rc e 1.347 Drafting Garoge sq, 't. =492 _ -- House if 16-6Ala Corral( ' �rSt Floor RanR Febnory fan O.T.03,2016 978-90.1-0131 J/:tr•-i'-O' SreN oF�'®:w::.,:am•✓9 £-�wi: ab�at4cn+5cw -� Bedrm 3 Bath M 8afh - cromt _ b � ------' Loft k Bedrm 1 Bedrm 2 Lfhng sq. IL =1.52f CalOniQl r House 18-6 _ Drafting Second Floor Plan Alan Carroll February 03,2016 978-902-001 II� _ TIC N WNOTICE TO F O A EMPLOYEES �YEMPLOYEES 7 ®w The pig iV�v. Commonwealth of assachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street,Suite 100,Boston,Massachusetts 02114 ® 2017 617®727-4900 ® http://%,ww.state.ma.us/dia As re aired by Massachusetts General Law,Chapter 152,Sections 21,22&30,this will give you notice that 1 we} base prow ded forpayment to our injured employees under the above mentioned chapter by insuring with: ACE GROUP NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBOR. . 02344-1450 ADDRESS OF INSURANCE COMPANY Y {6S62UB-OG23626-9-15} 08-15-15 TO 08-15-16 POLICY NUMBER EFFECTIVE DATES ® M P ROBERTS INS AGENCY 1060 OSGOOD STREET NORTH ANDOVER MA 01845 NAME OF INSURANCE AGENT ADDRESS PHONE# OLD SALEM VILLAGE OF NORTH HEPATICA DRIVE & ANDOVER CONDOMINIUM TRUST: MAYFLOWER DRIVE NORTH ANDOVER ® MA 01845 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases or personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the ® provisions of the Workers'Compensation Act.A copy of the First Report of Injury must he given to the injured employee.The employee may select his or her own physician.The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury.In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the 9 hiassachusefts-Bepaiiment of Public Safety Board of Building Regulations and Standar& cvmuru�(—,sap�rl License'CS-075302 BENJAMIN C OS00D z ®Old Village Lase North Andover MA 01"4 J - Expiration Commissioner 12/0412016 / �' (SILD zo/ 41.246.2800 y O ` 31.246.7598 / N / yeseng.com -- 5r 30, 2015 1 2004, / I i I / SN .. 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