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Home My WebLink AboutPermits - 16 COMPASS POINT ROAD BUILDING PERMIT ,ED 6,16 TOWN OF NORTH ANDOVER 0 APPLICATION FOR PLAN EXAMINATION Permit No#: Date Received "AT.ED ACHU SC Date Issued-j_ IMPORTANT: Applicant must com lete all ite as on this page 7 7 WCAT 10 0/ "o"P", PROPERTY OWN F K"F442,/0 QP, 2Q flCl ITEC upG MAP ICI Machine Slop-)/I,l ag, yes"'' 5 TYPE OF IMPROVEMENT PROPOSED USE —------ Residential Non- Residential ---------- New Building E One family O'Addition E Two or more family 0 Industrial 0 Alteration No. of units: U Commercial ------------- 0 Repair, replacement F Assessory Bldg 11 Others: EI Demolition 0 Other ............... 5 septic,, 'Elwell , ❑E1FloO`dpIbin District,', E Water/Sewer',,, DESCRIPTION OF WORK TO BE PERFORMED: Identification Please Type or Print Clearly ;? OWNER: Name: R11�4",(,Ll Cc, L CC Phone: Address: Ll f Y1(A ---------- t ont(a6' or Name. Phone: 3,46, 3 A 6,111�(),, Supe i`As"or',stons trUb ti ,L censeCxp n .... Flume 0 Db ARCHITECT/ENGINEER c,�- j) Lx,,LC, Phone: ;- ,]xC rA33"') Address: ,k �0., -Reg. No. 3,. .., 1 Q -- Col FEE SCHEDULE:BULDING PERMIT.$12,00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE-.'$_ Check No.: Receipt No.: Nor rE: Persons contracting wi istered contractors do not have access o t r Signature of Agent/Owner= Signature of contractor Plans Submitted ❑ Plans Waived ❑ ^ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OP SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Sw"nming 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 - UFORM PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on l Si nature �- :" COMMENTS GL HEALTH Reviewed on Si nature 53�-- 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 FIRE DEPARTMENT Ternp D t urnps#er on sae yes no Located of 124 Main 5fre'et Fire Department signatureldafie rnnnnn�ni�-c µORT1y �9 Town of 6Andover h n ver Mass - O LAKE /l_ 1 9 6A COCNICKEWKK`y S U BOARD OF HEALTH Food/Kitchen P -ERMIT .T L D Septic System C�rCCS C BUILDING INSPECTOR THIS CERTIFIES THAT ..................... .......................,....................... . ..............`.,.......................:.,.... has permission to erect .......................... buildings or �?!Y�,1.�� ...'.. .1..°y. J�.. .�. D.,; Foundation `. �. � L � Rough to be occupied as .........J....',� �% I G�1yaf. ........................................ Chimney provided that the person accepting this permit shall in eve 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 ® TS ELECTRICAL INSPECTOR UNLESS CONSPWNI Rough Service .... ...,..76�jkLDING I GAS INSPECTOR ®ccu2ancy Permit Required to Occupy .Ruildin 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. ��. a FA iATE(MIDENYYYY) CERTIFICATE LIABILITY INSURANCE_ 3/10/16 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE IS SLHNG ll+f.SURER(S), ALFrHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsemen s). PRODUCER CONT CT fifAEAE: Coonan Insurance Agency, Ina. PHONE �A%.� (508).- 9)37-71.22 A N (549) 987-7352 267 Main Street aDo9ss: Cincl @ coonaninsurarice.com Oxford, MA 01540 NAEC -----------•-------------------- INSURERA:L:Lbert lr,-.Yhutuai _-----------------------' INSURFJ'1--- INSURER a-.Travelers TJK, Inc. imsuRERC:Saf_e��r xYzBurance PO Bow 12 - ItWREA D; South Grafton, MA 01560 INWRERE.:_ INSURER F, COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ESSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSEONS ANDCONDITIONS OFSUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID Ct.AIMS. fiVSR -------- ---- At�LI UBR--------_ -.--- ._ POt[CY EFF j POLICY OSP_,_— LTR 3 TYPEOFINSURANCE I R' POLICY NUMBER ,�{flDL1fY Mh9lDC#YYYY LIR�TS 1 GeNtOtRLLIABELiTY l %$0-'335 11703-15 z�.13115 11/3/,_s' EACH OCC URRFNCE 000_000 cou+lsRCIALGs NErv�LLIAaIuTY �s€� 300,000 _ _- CLAIMS,AADE ---�OCCUR VEC0 EXP(Ary_om Person) S T 5 000 ! _ _ _ _--- 1 ) I �r PERSONAL&ADWNJURY_ I5_ i0 Q.Q.c Q�a �- ----- --- ; i GENERAL AGGREGI.TE s 2 000 000 _ _— .... _.__ ..__.1 __._ GEN'LAGGREGATEL3MITAPPLIES PER I I l PRODUCTS-CO':PIGPACGv 5._ 2.,000,000 `.l$ POLICY �,�07 � � LOC AUTOMOBILE LIABILITY 4/1/15f 4/1/16 CO INEDSING E EI",'IT c C 13952949 € ANYAUT'O I i l i =. 80D4tYlNJURY(Per pssscn).- 100,000 ALLouvnED x SCHEDULED BODILYINJURY(Peraccidanl)! S 300 000 i f AUTOS AUTOS I +__.—_--,_..—_— NON-OMED PR6PERTY DWAGE � c HIRED AUTOS AUTOS LP9rcc<12 tiv- - 300000 --- UN RELLALIAe OCCUR :_EACH OCCURRENCE S EXCESS LIAO CLAlMS_MAO;� i I + I I AGGREGATE k EXCESS RETETETIONS E VORKE RS COMPENSATION � q�3B-9914>I01-3-3 6 { 1/26/16. 1/26/17 X , '7-%+ 8.`...__�E �- AND EMPLOYERS'LIAGILFTY Y I N f { ANYPROPRIETORIPARTNERIEXECUTivE _E,L PC hi AC CI CENT.-.____'-$_-- 00.,000— ! OFFiCERIMEMSER EXCLUDED? N!A; i (Mandatory in NH) !FL_0115 ASE-Fri 0" PLQYEEI- if yes describe under — 'D SGRIPTIONOFOPERATIONSbelnw I } i i I EL.DISE:ASE-POLICY LAW S 500,000 A {Contractors Equipment TM 8988315 5/8/1S S/t3/3 6 Property Limit 79,000 { j Deductible 1,000 DESCRtPTIONOFOPERATEONSILOCATIONSIVEHICLES (AttachACORD 101,Additional ResreksSchedule,itn;ore.9 pare isroqui red) j CE=RTIFICATE HOLDER CANCELLATION SHOULD ANY OF TIME ABOVE DESCIRZI ED POLICIES BE CANCELLED BEFORE TK EXPIRATION DATE THEREOF, NOTICE WILL HE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cincly Davis (D 1988-2090 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The AC ORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: tbui:ns@blaokbrookrealt)r.com i I F Board of BuWiwig C' egkfl Tions and Standards License: CS-059359 4,h+XE@"rnYlllr,ntlw:bn'w `"o4V�'B`fl"^J 4.,::kE" n iioO TIMOTHY MICHAEL BARS OW %i' P.O.BOX#12 SOUTH GRAFTON MA 01660 Z�.:T Expo ratmrw Cori l°jfnt ss wrner 01/2412018 �,,.qir��°`'IRaJ'air/rcaYArr^rerwl'"P�r�c"sl" r,�tvr<'�R,r�tmfl,�� Office of Consumer Affairs&Business Regulation tk aVa �° MOMS IMPROVEMENT CONTRACTOR �+ , Registration. 143758 Type: Expiration. 7/29/2018 DBA BARLOW BUILDING TIM BARLOW 13 DEPOT ST S.GRAFTON,MA 01560 Undersecretary I