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Home My WebLink AboutBuilding Permit #328 - 10 MAIN STREET 10/23/2006 TOWN OF NORTH ANDOVER NORTH APPLICATION FOR PLAN EXAMINATION Ott\ED "6" 6 o i Permit NO: � Date Received Area �9pSAM Date Issued:/O ��s� D� s CUS� IMPORTANT: Applicant must complete all items on this page LOCATION 1O n- r� Print PROPERTY OWNER Tt-i„ r1 o r (Lec.1.1j. 1—L-(- Print MAP NO.: PARCEL: �' ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential ❑New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: Z Repair, replacement ❑ Assessory Bldg ❑ Commercial ❑ Demolition ❑Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED �— (fie Q 10-Cerrsa_r, - W"C Identification Please Type or Print Clearly) OWNER: Name: 12 a hv LLC Phone: 7- 7 3-2 13 Address: to to o.:ri S CONTRACTOR Name: Phone: 9?q- 45z- Zu3 C 2 Address: S4 Sj 6n`C--i F:)e- 58- t Lbw c--u t n t (z-S c� Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost :$ 2 5 4 C . c_o FEE:$ Check No.: 3Y� Receipt No.: Page 1 of 4 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 i TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art ❑ Swimming Pools ❑ ❑ Well F1Tobacco Sales ❑ Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site ❑ Private(septic tank,etc. Electric Meter location to project NOTE: Persons contrac g with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ownel Signature of contractor Plans Submitted ❑ P Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING& DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH � • F1 ❑ COMMENTS I I ;SIRE DEPARTMENT -Temp Dumpster on site yes no Fire Department signature/date 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 i Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA— For department use Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTM ENT:BPEORM05 Created 1MC.Jan.2006 i ' Location 10 M4Z*7 S1 No. Date TOWN OF NORTH ANDOVER MORTh D t Certificate of Occupancy $ r4 •so .•"3 Building/Frame/Frame Permit Fee $ s�cwust 9 Foundation Permit Fee $ Other Permit Fee $ �'. TOTAL $ Check # !L 19726, Building Inspector "°"r" TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT ,e 1600 Osgood Street Building 20, Suite 2-64 9"'T CHVaNorth Andover, Massachusetts 01845 Gerald A. Brown Inspector of Buildings Telephone(978)688_9545 H0�IEOWNER LICENSE EXEMP Fax (974) 688-9542 TION I� Plea,_ �e i_print DATE: r) JOB LOCATION: c� Number Street Address Map/Lot HOMEOWNER n (S Name2- 2- 13? Home Phone Work Phone PRESENT MAILING ADDRESS Gv r) f �� City Town S f State Zip Code The current exemption for"homeowners"was extended to include owner-occupied to allow such homeowners to � p dwellings to two units engage an individual g mts or less and ual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Buildin Co Applicable codes, by-laws, rules and regulations. g de and other The undersigned"homeowner"certifies that he,'she understands the Town of North Andover Building minimum inspection procedures a ldm De P and requirements and that he/she will comply g Department requirements. pl with said procedures and HUMEOWNERS .SIGNATURE APPROV,\I.OF BUILDING OFFICLa Revised 111.'005 - — Form H>ilo wncs�.ecmplinn 3CiARD F,iFPF>L.5 ;5;5 HFaLFHPLANNIN'C, :o, _ A yr 4 1) � tikYr��i a i �1� t•9 �:Vv .,` �=�� I � , �y0. ��® 4 "M�# ` y 1�+��0 � SIR .. �. 'Y�^a/ • '\ � 4�Y11 ��. .. i:\fifes "i �- J ti�� i�Yr./• a...r ((i�v�}r� �+A'1Y 1I,. 14, 40 �• �r�r i'ti � 10 �N� � Y �+ i �� i +^•4� �SII�.��5 ♦t �I�.rw � � d. A � �� Llt�! fi �1:►t �� .� �� fi, y ,. � ��; �•�1ti.1.� fir`• _ _ \ \� @ A21 • » AXzv& a\ \ ^ rrt ' ; - - z� �••� a i -�r�rio rJL 1 b F'19 � Cd,ARANTEED ALUMINUM &. VINYL INC. P. 01 349 Bridge Street LOWELL, MA 0186o Phono: (978)452-2392 (978)469-780.1 INVOICE Pax.(978)452-2908 www.guarwindow.com INVOICE TO NO. INVOICE DATE TQIPPED OUR ORDER NO, YOUR ORPBR NO. SALESPERSON ----- TERMS.� — SHIPPED VIA PPD.OR CO; OUANTITY —.....�_._ D E SCR I P T IO �..__ - -----__---- -w�_--N --- PRICE. AMOUNT tic DOPucATE ._,. n AUG-09-2006 09 :59 AM P . 01 NFRC MFG CODE; SII. NFRC SERIES 4000 Dual Glazed Vinyl Double Hung NatioMlFeneatratlon Low E Glass AaflngCoUndlO ENERGY PERFORMANCE RATINGS U-Factor(U.S,/1-P) Solar Heat Gain Coefficient 0.36 0 .32 ADDITIONAL PERFORMANCE RATINGS Visible Transmittance 0 .55 E pulates that these ratings conform to applicable NFRC procedures for determininp whole ance,NFRC ratings are determined for a fixed set of environmental condltlons 2 a size,NFRC does not MCommend ony product and does not warrant the suitability of any se.Consu anufacturor's Ilteraturo fa other roduct rformance 4rtfamatian, specific u it m P f� www,nfro,org This window is ENERGY STAR® qualiiled in the highlighted region(s), 4000B Desl?n Pressure Rating Retings or sizes up to 48"w 30" ' OP-25 Retings for sizes up to 44" x 60" : OP-30 QUALITY CERTIFICATION I Merchants Mutual Insurance Company B % SINESSS Bu .nelec s essowners Policy Declarations Transaction Type: New Bus i ness Businessowners Policy Date Prepared: 03/28/06 Policy Number: BOP 1033964 D I RECT BILL 1. Named Insured and Mailing Address: 2. Your Agent: 47759/NER06/038 TRIPNORTH REALTY LLC FRANCIS E. PROVENCHER INS AGY CLO JOHN TRIPODIS 530 ROGERS STREET 17 MAPLE AVENUE LOWELL, MA 01852 NORTH ANDOVER, MA 01845-2411 3. Policy Period: From 03/31/06 To 03/31/07 12:01 a.m. Standard Time at location of designated premises. 4. The Named Insured is: LLC 5. Business of the Named Insured: BU I LD I NG OWNER-OFF I CE OCCUPANCY 6. In consideration of the premium, insurance is provided the Named Insured with respect to those premises described in the schedules below and with respect to those coverages and kinds of property for which a specific limit of liability is shown, subject to all of the terms of this policy including forms and endorsements made a part thereof. Loc. No. Bldg. No. Address SCHEDULE OF DESCRIBED PREMISES i 001 001 12 14,16 MAIN STREET NORTH ANDOVER MA 01845 002 001 10 MAIN STREET NORTH ANDOVER MA 01845-2410 I BUSINESS LIABILITY LIMIT OF INSURANCE General Ag regate $ 2,000,000 (Other han Products-Completed Operations) Business Liability $ 1 ,000,000 Each Occurrence Products-Completed Operations Aggregate $ 1 ,000,000 Medical Expense $ 5,000 Any one person Fire Legal Liability $ 500,000 Any one fire/ explosion AUTOMATIC COVERAGES LIMIT OF INSURANCE Business Income and Extra Expense Actual loss sustained - not exceeding 12 consecutive months - AUTOMATIC COVERAGES CONTINUED ON NEXT PAGE - TOTAL POLICY PREMIUM: $2,741 .00 INCLUDES TERRORISM RISK INSURANCE ACT PREMIUM OF: $15.00 Countersigned: Authorized Representative: MU 7557 (0196) INSURED COPY r Merchants Mutual Insurance Company Businessowners Policy Declarations Policy Number: BOP 1033964 DIRECT B ILL 1. Named Insured and Mailing Address: 2. Your Agent: 47759/NER06/038 TRIPNORTH REALTY LLC FRANCIS E. PROVENCHER INS AGY C/O JOHN TRIPODIS 530 ROGERS STREET 17 MAPLE AVENUE LOWELL, MA 01852 NORTH ANDOVER, MA 01845-2411 3. Policy Period: From 03/31 /06 To 03/31107 12:01 a.m. Standard Time at location of designated premises. AUTOMATIC COVERAGES LIMIT OF INSURANCE Accounts Receivable *$ 5,000 Newly Acquired or Constructed Property - Building Coverage - 25% of limit but not more than $100,000 Off Premises - Building Coverage $ 5,000 • Valuable Papers and Records - Cost of Research *$ 5,000 Fire Department Service charge $ 1 ,000 Pollutant Clean Up and Removal $ 10,000 Outdoor Property ($500 maximum per tree/shrub/plant) $ 2,500 Outdoor Signs (Attached) *$ 1 ,000 Equipment Breakdown Included - Spoilage *$ 25,000 * Refer to BusinessComplete and/or Optional Coverages (if applicable) for Additional Limits OPTIONAL POLICY COVERAGES Employee Dishonesty $ 10,000 Occurrence - Total Policy Limit DESCRIPTION OF PREMISES Loc.No. Bldg.No. Address 001 001 12 14,16 STREET Deductible: $2,500 Business Occupancy: OFFICE - NOT OTHERWISE CLASSIF COVERAGE LIMIT OF INSURANCE Building - Replacement Cost $ 485,000 Building limit automatic annual increase of 101/o Money & Securities10,000 Inside 110,000 Outside OPTIONAL COVERAGES SPECIFIC TO PREMISES SHOWN ABOVE BusinessComplete Endorsement - For Coverages refer to MU7972(07/04) MU 7557 (0196) �k Merchants Mutual Insurance Company r Businessowners Policy Declarations Policy Number: BOP 1033964 DIRECT B ILL 1. Named Insured and Mailing Address: 2. Your Agent: 47759/NER06/038 TRIPNORTH REALTY LLC FRANCIS E. PROVENCHER INS AGY C/0 JOHN TRIPODIS 530 ROGERS STREET 17 MAPLE AVENUE LOWELL, MA 01852 NORTH ANDOVER, MA 01845-2411 3. Policy Period: From 03/31/06 To 03/31 /07 12:01 a.m. Standard Time at location of designated premises. i i Mortgage 1 PENT UCKET BANK 1 MERRIMACK STREET PO BOX 791 HAVERHILL, MA 01831 DESCRIPTION OF PREMISES Loc.No. Bldg.No. Address 002 001 10 MAIN STREET NORTH ANDOVER MA 01845-2410 Deductible: $2,500 Business Occupancy: OFFICE - NOT OTHERWISE CLASSIF COVERAGE LIMIT OF INSURANCE Building - Replacement Cost $ 305,000 Building limit automatic annual increase of 101/6 Money& Securities10,000 Inside 110,000 Outside OPTIONAL COVERAGES SPECIFIC TO PREMISES SHOWN ABOVE BusinessgCogmplete Endorsement - For Coverages refer to MU7972(07/04) 1 PENTUCKET BANK 1 MERRIMACK STREET PO BOX 791 HAVERHILL, MA 01831 FORMS AND ENDORSEMENT ATTACHED AT INCEPTION BP0434 0197 BUSINESSOWNERS SPECIAL FORM COMPUTER COVERAGE BP0456 0197 UTILITY SERVICES - DIRECT DAMAGE BP0523 1102 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM BPO542 1102 EXCLUSION-PUNITIVE DMGS RELATED TO CERTIFIED ACTS OF TERROR MU7794 0701 FINE ARTS COVERAGE ENDORSEMENT MU7972 0704 BUSINESS COMPLETE SUPPLEMENTAL COVERAGE ENDORSEMENT BP0002 1299 BUSINESSOWNERS SPECIAL PROPERTY COVERAGE FORM BP0006 0197 BUSINESSOWNERS LIABILITY COVERAGE FORM BP0009 0197 BUSINESSOWNERS COMMON POLICY CONDITIONS BPO108 0398 MASSACHUSETTS CHANGES BP0417 0196 EMPLOYMENT RELATED PRACTICES EXCLUSION BP0419 0689 AMENDMENT LIQ LIAB EXCL/EXCEPTION FOR SCHEDULED ACTIVITIES BP0496 1001 PREMIUM AUDIT ENDORSEMENT BP1004 0498 EXCLUSION OF COMPUTER-RELATED LOSSES IL0021 0498 NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (BROAD FORM) MU 7557 (0196) Merchants Mutual Insurance Company I yj Businessowners Policy Declarations Policy Number: BOP 1033964 DIRECT B ILL 1. Named Insured and Mailing Address: 2. Your Agent: 47759/NERO6/038 TRIPNORTH REALTY LLC FRANCIS E. PROVENCHER INS AGY C/0 JOHN TRIPODIS 530 ROGERS STREET 17 MAPLE AVENUE LOWELL, MA 01852 NORTH ANDOVER, MA 01845-2411 3. Policy Period: From 03/31 /06 To 03/31107 12:01 a.m. Standard Time at location of designated premises. FORMS AND ENDORSEMENT ATTACHED AT INCEPTION MSIU05 1199 FRAUD TIP LINE MU7436 1203 SPECIAL POLICY AMENDATORY COVERAGE ENDORSEMENT MU7437 0695 BUSINESSOWNERS INSURANCE POLICY MU7517 0495 TOTAL POLLUTION EXCLUSION ENDORSEMENT MU7557 0196 BUSINESSOWNERS SELECT DECLARATIONS PAGE MU7771 1000 EQUIPMENT BREAKDOWN ENDORSEMENT MU8137 0106 NOTICE-OFFER OF TERRORISM COVERAGE AND DISCLOSURE OF PREMIUM I MU 7557 (0196) I ,AORTH Town of Andover No. 0 AKII over, Mass., 16 L coc .C.e"'.C. RAT ED S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System 4? BUILDING INSPECTOR 4 .............. THIS CERTIFIES THAT......Trlfojo��+k.... ... ....Z .................................. Foundation • has permission to erect.............. ..................... buildings On ...�.t-o.........tvw*A i1..r r.................................. Rough ......... -Wow.....(........... Chimney to be occupied as....AT!!.... ........"4.4 ........................................................ provided that the person accepting is permit shall in every respect conform to the terms of the application on file in Final 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 Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUS Rough C7T . .......... .................... Service ECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.