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Home My WebLink AboutBuilding Permit #83 - 106 MARBLEHEAD STREET 8/1/2007 Location A ��a ' / ✓ '� � No. Date �aRTh TOWN OF NORTH ANDOVER y Certificate of Occupancy $ _f Building/Frame Permit Fee $ 1 s�CNus y t Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 20453 Building Inspector NOK IH BUILDING PERMIT °� 0 TOWN OF NORTH ANDOVER F 4 '� APPLICATION FOR PLAN EXAMINATION qe c«.u.x Date Received °"�*■°•'"`y'�� Permit NO: ��SSACHu`�� Date Issued: � ' .o IMPORTANT Applicant must complete all items on this page � �� Ins� TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential ❑ New Building ❑ One family ❑ Addition %Lefwo or more family ❑ Industrial ❑ Alteration No. of uriits: Q Commercial QAepair, replacement ❑ Assessory Bldg [I Others: ❑ Demolition ❑ Other �w 44. 7i TMUE (I} dd MIN -. �..,. DESCRIPTION OF WORK TO BE PREFORMED: L�— II entifi`c on Pl ap Type Print Clearly) O y y OWNER: Name: Phone: Address 11- G� VI ARCHITECT/ENGINEER 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: $ 00 FEE: $ Check No.: Receipt No.: a v NOTE: Persons contract' 'th unregisteredcontractors do not have access to the guaranty fund 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 ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified 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) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 j Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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:BPFORM07 Revised 2.20117 Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming 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 - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑� 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 Drivewa P rmit Located at 384 Osgood Street 77 D rrtP c L ocated -atl4la�r� #reet I TV s � -r" :s' .cY' Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 section 21A—F and G min.s10o-s1oo0 fine NOTES and DATA— For department use ❑ Notified for pickup - Date .................. Doc.Building Permit Revised 2007 NORTfy own of over 0 V" No. g3 _ �•i� �- Q dower, IVlass. O = LAK > O� COCHICKEWICK BOARD OF HEALTH PERMIT,. T D Food/Kitchen Septic System 0006 BUILDING INSPECTOR THIS CERTIFIES THAT......... i !r!!�i... .................................................................................................. .......... Foundation has permission to erect..... buildings on �..� 00 � 1 . Rough ..................... ./..Q..� Q. ........................... ...4.. to be occupied as ' „ Chimney f.. .. provided that the persona opting this permit shril'�ery 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 PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUC TS Rough ............ ...... .......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR 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. SEE REVERSE SIDE Smoke Det. :i LLILt ?:08 .AM _R0, ONA.'.,_ ?AN GL=QN= b" ia-':J _.3::a=�-�l? .',S'1'.'3'1=� ?::_-.. OOi '-_ JUi ACORD. CERTIFICATE OF LIABILITY INSURANCE DATEQeIMIDDKYYY) 08/01/2007 ;PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MacDonald&Pargione Insurarce Agency, Ino. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE j P.u. BOX 42$ HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 104 Main Street — Nortf-Andover. NIA 01845 'INSURERS AFFORDING COVERAGE MAIC it —� Frank Stewart d/b/a Stehvar-Electrical Co T—;_�_PREFERR.ED'�t!�iTURL IfJSURANCENSURED 1 115 Bluerd,?e Road ;:r.'3;F = THE HART=ORD GROUP _--- I---� No Andover,MA 0184v CNE BEACON iNEURANCE -- uJsu2 �D. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEC TO THE INS IRED N4MIED ABOVE FOR THE POLICY PERICD INDICATED.NOT,PJITHSTA.NDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CR OTHER DOCUMENT I,NITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR IMAY PERTAIN,THE INSURANCE AFFORDED BY THE POUC:ES DESCRIBED HEREIN IS _DEJECT TO ALL THE TERMIS. EXCLUSiOrJS AND CONDITIONS OF SUCH POL!CIES.AGGRE3ATE LIMITS SHOWN PflAYHAVE BEEN REDUCED BY 0;= D CLAIMS. L•INSr2~IFoDC'LI-- i•Cl_ EFFEGTiVE POL!CYEX?IRAT^N Ll_—S_R._IINSHOI �E_OF INSURANCE POLICY NLtMBER � OATE i!AM;DO/nl ,ATE iMFAfDDNY1 LIMITS I GENERALLIABILITY CPP!J1 0 8 ^,L' 6 12/C21 812/021/2007 E;= URE;:cE A 1 6' ? 20'� $ 1;00C,000i �� : ti wc. �� ! Mr�ERCIALi,ENEF.ALL1.4E.1 i aF= =c;c TS 100,0/'0 ! CLAI!JSh'ACE ,,^C.:J. I V� I i'�J 4 .'OQL.: I ` y -'E.-NEPAL 3,OCG.Qo I GE'YL AcGREGA i E L1M1T,'J-*R_ES F'EFi: --i Orr, Dt.:T=. Jh5?l%r N jl 5' 3i.000!.OX' .PFG-X,POLICY 17 f.;;- -t— C L±UTOIAOBILs LIABILTY ' _ P Ih11- '!5c5014/1 0001,. /2nODS ;-L- II"� ANYAUTO i j _c=aciide�f; $ kLL QVf'NED P.UTOS J�!SCHEDi.V=DAUTOS IJ Pe persc 1 OOU 000 ! iX HIRED A -iS -4—fL-----_---------I-----'------J w_ru.ILP e NON- 1,000,000 1 Ow!J.DAUiC'` i :pe.a-ddenii� I" 1 l_ 2 I ! Fe accid�nq 00,000 1 ----i GARAGELIkBILITY � ~�_ � __�-p0i•ILY-Eut.�'.^I rl.�" $ —�kPn-AUTO L�.-�_.rI _L— _— •I J-Ii ONO, xCESSIUMBRELLALIABILITY `_-41 OrCGF. CLhRrISMApE .AGGREGATE $ I I I I S DEDU..TIELE . RE-ENTICw 5 --- y---- B WORKERS COMPENSATIONAND ! 08 WEC RH2343 08/09i2007 D8!09/200b LriLears ER EMPLOYERS'LIABILITY 4141'PPOPFLT:F-21PAo.T7-!ccy/E7�Ei.1J?PSE j `-- 500,000 i UDEN' E L D!ScASc-EP.E!sgFLGYE= 13 500 000 _'.e=rnb=uncle! � i -- °UEC:A_F?D'JiS'.,tiS05!I^,,+! I Do -�-, t ,AEL OTHER DIS zE 0-;UCY-.1m1T 14 5500.000 i I — I I DESCRIPTIONOFOPERATIONS 1LOCATIONS1VERCLES1EXCLUSIONS AD EDSYENDORSEMENT1SPECIALPROVISIONS Job Site: Rercvations 106 814107 Marblehead St., No Andover. MA 0184 I i i CERTIFICATE HOLDER CANCELLATION ! SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION I Town of fdorth Andover CATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 080 g00 St NCiICE TO THE CERTIFICA-HOLDER NAMED TO THE L---F",M FAILURE TO 00 SO SHALL North:Andover. Mid 01845 IMPOSE NO OBLIGATION OR UABILIT"OF AN"FGNO UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES_ kUTHCRIZEC REPRESEK4TIVE — Attn, Building Dept , �,,• - I ACORD 25(21001/08) 0ACORD CORPORATION 1988 f , Y NORTa TOWN OF NORTH ANDOVER ° '„•' �� OFFICE OF O? `` r M ••OA BUILDING DEPARTMENT 4L i * 1600 Osgood Street Building 20, Suite 2-36 North Andover,Massachusetts 01845 1ss�cmnst Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Pleawprim III DATE: JOB LOCATION: �U j' ' j o 0' Number Street Address MapJL.ot HOMEOWNER � - � _ �r.�v� � . 9 7�' 6�'��'� g � e g7PTO c1 g8'3 Name Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for”homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who floes not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) I 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 Building Code and other Applicable codes,by-laws,rules and regulations. �I The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. / HOMEOWNERS SIGNATURES—r�/� APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Foam Hocneowons E=Wdon BARD OF \PPEALS(M-9541 CUNSERVXF10N 638-9530 HEALTH 08-95.30 PL.LNNING 688-9535 I JMl„ '('77LY7L Ylf//fllrt'�f7 f.�.: �rr:tq'.l.'�.C<G6l�i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 069242 Birthdate: 05/13/1964 Expires: 05/13/2008 Tr.no: 21117 Restricted: 00 FRANK R STEWART 115 BLUERIDGE RD N ANDOVER, MA 01845 Commissioner 1