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HomeMy WebLinkAboutBuilding Permit # 1/9/2017 BUILDING PERMIT pk � ED. �YLe TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit Nod: 1 Date Received-_--al 7RnR STED lY¢� SAC 14 151, Date Issued: LVIPORTANT:Applicant must complete all items on this page r k s �b`• IOCATI�N PROPERTY®�lVNER_�_ � rl '"` ' 'w Pnnt 1��]Year Structure e no PARCEL ZONING DISTRICT H[storic ®i"str[ct e no MAP n S y. Mae i e hop V[Ilage -Y -- ne . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ Qae family ❑Ad ition Kfwo or more family ❑ Industrial lteratlon No. of units: ❑ Commercial ❑?emolition pair, replacement 0 Assessory Bldg [I Others: ❑ Other 5t[cY Well M Flaodplairi D Wetlands 1N2tished D[str[nt. _ DESCRIPTION OF WORKTO BE PERFO/RMED. rz ���� D i2 �c�J�!/I `"�"� .L•zGL v %Z6- ver`�?G. !f1 �`�b- VBA Bit do �var O�• /�e L,�� ����� e`�tS, Identification Please Type or Print Clearly' OWNER: Name: 1�� L v�. Phone: 770 -3 786 Address: I - ©, Asx 7k J o Arn o e,< l4 . Frtkle-e 77 E,* L e•.�S `. Coritracfior Naffie,z35 s. -ov PFioiie : 54 -affl.,-:#G0. IL rv[sors CeansrtictloriLicense �-p j�,3� � Exp: Datela-L��o ExpQaE 6e Improv�men�License = - ARCHITECT/ENGINEER- Phone.- Address: hone:Address: Reg. leo. FEE SCHEDULE;RULDfNG PERMJT.$12,Oo PEI?$1000.00 OF THE TOTAL ESTIMATED COSTBASED ON$125.00 PER S_F. [- Jotal Project Cost: $ d# - FEE: $_ (� �- Check No.: Receipt NG_: 3 / 4/ 1 � NOTE- Person,��tr `�g wit z registered contrae rs cio x�ot�i��e: esu t e guarantyfund unci' :�inr rrn4,,AiP'nwYl r SiC! Uri Df contrac F='- i Enter construction cast for fee cal - North A►1dOVeI'Fee Calculation Construction Cast $ 25,000.00 m $ - $ 300.00 Plumbing Fee $ 37.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 37.50 Total fees collected $ 475.00 32 and 34 Johnson Street 701-2017 on 1/9/2017 interior renovations 1 1 i i I Enter construction cost for fee cai - North Andover Fee Calculation 1 Construction Cost T 25X0.00 m $ - $ 300.00 Plumbing Fee $ 37.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 37.50 Total fees collected $ 475.00 32-34 Johnson Street 701-2017 on 1/9/17 interior remodel OQRTH '9 own of _ .A;: bAndover ® No. [ �" d z h � /► a I'AME h ver, Mass, / 7 coc.ucHew CK ATED S BOARD OF HEALTH Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ....5,.......�OS�.�r.. . ....... ...�C'. .............. `• . . .. .. .....13..4. 70ONS-0� Foundation has permission to erect .......................... buildings on .. ........ .. .. . Ap Rough to be occupied as tMt*. . 1/ 1.... ..... .... .�~ ...... Chimney provided that the person accepting this permit shall in every respect con orm 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 PLUMBING INSPECTOR Construction of Buildings in the Town of North Andover. Rough PERMIT T LD VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMITI IN 6 MONTHSELECTRICAL INSPECTOR, UN L C Rough ..... ......................... Final Service .. BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Buildin Rough Display in a Conspicuous Place on the Premises -- Do Not Remove Fnai No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. DATE(MMIDDIYYYY) ,4ca> rr� CERTIFICATE OF LIABILITY INSURANCE 1/9/17 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 ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). PRODUCER CONTACT NAME: Sandi Munroe _ M.F. Roberts Insurance Agency PHONE (978) 6$3_8073 FAxNe (g78) 683-3147 1060 Osgood Street E-MAIL ADDRESS: sandi@mprobertsinsurance.com North Andover, MA 01845 INSURER(S)AFPORD€NG COVERAGE f ! NAIC!I INSURERA:Travelers Insurance Co INSURED INSURER B: CENTER REALTY TRUST INSURERC: _ P.O. BOX 676 INSURER D: — NORTH ANDOVER, MA 01845 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICES 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 ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANDCONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. €NSR -- - - ---- -- ADDL SUER - -- ----- -- POLICY EFF POLICY EXP - LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDNYYYI IMMIDEVYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERALLVIBILITY PRERENTED __SO(Ea accum ce $ CLAIMS-MADE L]OCCUR MED EXP(Arryone person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GENTAGGREGATEL€MITAPPLIESPERPRODUCTS-COMPlOPAGG $ POLICY PRO- LOC _ $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accid_ert $ ANYAUTO BODILY INJURY(Per person) $ ALLOWfED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED Pecarwid nDAMAG£ $ . HIRED AUTOS _AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION UB3F367937 2/10/17 2/10/18X WCSTATU- OTH. AND EMPLOYERS'LIABILITY ORYLJM I ER ANY PROPRIETORIPARTNERIEXECUTfVE YIN N!A E.L.EACH ACCIDENT $ 500,000 OFRCE RAKE MBER EXCL LO ED.2 (Mandatory in NH) E.L.D€SFASE-EA EMPLOYEE $ 500,000 If yes-describe under DESCRIPTIONOFOPERATIONSbelow £.L.D€S EASE-POLICYLIMIF $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,AddiSonal Reaurks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. NORTH ANDOVER, MA 01845 AUTHORIZED RESENTATIVE +�' �� © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Office of Consumer Affairs&Business Regulation == HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only Type: Corporation before the expiration date. if found return to: Registration ExpirationOffice of Consumer Affairs and Business Regulation - 186186 10/07/2018 10 Park Plaza-Suite 5170 Boston,MA 02115 Key-rime, Inc benjamin Osgood 10 Hepatica Drive c North Andover,MA 0185 _ undersecretary Not vaiiq without Ognature Massachusetts Department of public Safety Board of Building Regulations and Standards r License: CS-075302 Construction Supervisor' BENJAMIN C OSGOOD 69 OLD VILLAGE LANE NORTH ANDOVER MA 01846 r-l""A `-A---- Expiration: Commissioner 12/04/2018 I I