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Home My WebLink AboutBuilding Permit #84 - 107 MARBLEHEAD STREET 8/1/2007 Noes e M BUILDING PERMIT °f�t`" q"o TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION * ` Permit NO Date Received �SSACHUS�� Date Issued: IMPORTANT Applicant must complete all items on this page 1A c ssri eye no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition Vwo or more family ❑ Industrial ❑ Alteration No. of units: Q Commercial epair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other IV DESCRIPTION OF WORK TO BE PREFORMED: IdentificationPlease Type or Print Cle rly) OWNER: Name: t=�� Phone: Address ,, �� 'e 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. n/ Total Project Cost: $ FEE: $ -7 Check No.: 7 / 1 Receipt No.: C�o`1 S NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ;S=ignature of erk#/Ownr _ rtnatur ofcontrctos l 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) ❑ 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 Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report o 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 2.2007 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 PLANNING & DEVELOPMENT F1DATE REJECTED DATE APPROVED ❑ COMMENTS CONSERVATION DATE REJECTED DATE APPROVED ❑ ❑ 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 Located at 384 Osgood Street Driveway Permit FARE flEPAR 'ME`NT 'rp7y D4�tGo �te- hp, ,zC Located 1�4 Main S#ree# Fllreepar#rnerat sllgnati�re/carae � � N Revised2:Z0u` NOK 11y -BUILDING PERMIT b,°�.0%.90 "° f • • w"r"nVER ° - _ .."•.h s „. y„ay.w3`� .z $`u .. "i"'r w¢ ension ��.•,:� £ � �.max;�, Number of Stories: --__ Total square feet of floor area, based o Total land area, sq. ft n Exterior dimensions. J ELECTRICAL: Movement of Meter location, Electrical Ins : Movement Pectotion mast or service drop requires a Yes DANGER ZONE NO approval of MGL Chapter 166 Sect onrETURE: and G Yes min.$100_$1000 fine NO NOTES and DATA_ For depart use I 1 � I i f 0 Notified for pickup - Date ..._ Doc.Buildin pe _.__........................_._. ................._............. Permit Revised 2007 _............_.......-..._._.._..............................._.............._, Location /0 -4 No, Date 0 NORTH TOWN OF NORTH ANDOVER 0� .Sn F 9 41 ' Certificate of Occupancy $ �SSACH usEt� Building/Frame Permit Fee $ T- Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1 e 20452 v Building Inspector t4ORTH Town of Andover 80 . No. 7 0 Q7 44 0� - dower, Massoffb 040 K 6 COCHICHE ICK TE BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System �,; BUILDING INSPECTOR THIS CERTIFIES THAT....... .............YdNOW........... ............................................... Foundation has permission to erect............................. buildings on....1.0 ... I...0.)......... Rough I U" to be occupied as... 00 Chimney .............. ........I...... ...............................................I............................... provided that the peiAiziAg pe shall I ry respect conform to the terms of the application on file in, Final this office, and to the provisions of the Codes and By- ws 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 mm 'j ELECTRICAL INSPECTOR UNLESS CONSTRU ON T TS S Rough ......................................... ........ Service BUILDIN R Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Firial No o 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. pORTir TOWN OF NORTH ANDOVER ° �,`•• ,•�"o OFFICE OF I. BUILDING DEPARTMENT �•t ; + 1600 Osgood Street Building 20, Suite 2-36 �.'�:,;,.:•�` North Andover,Massachusetts 01845 1SSACM/gt� Gerald A Brown Telephone(978)688-9545 Fax (978)688-9542 Inspector of Buildings HOMEOWNER LICENSE EXEMPTION Please>[t DATE: r a JOB LOCATION: 1 U �--Number Street Address MaPIA HOMEOWNER l A;ky-a ,,�v A . 17 7�a �7 � I �1 5 uO• ��/ ��°`� °Ll R13 Name Home Phone Work Phone PRESENT MAILING ADDRESS— ^4 D 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 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 Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned-homeowner-certifies that hetshe understands the Town of North Andover Building Department minimum inspection procedures and requirenients and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATUREy` APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption BOARD OF WPEALS(,33!)5:11 C0N'S.ER%-.vr1t1\638-9530 1TE.UA'H 688-95-30 PL.V%N[`G f,"-9535 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 G c, N ANDOVER, MA 01845 Commissioner AM -MA-C-�014ALD 2k'JGI;--,Ij-- -)C"' ACRD CERTIFICATE OF LIABILITY INSURANCE DATE(MWOONWIO 0810112007 AS A MATTER OF INFORMATION ONLY AND CONFERS 140 RIGHTS UPON THE CERTIFICATE PRODUCER THIS CERTIFICATE IS ISSUED MacDonald&Pangione Insurarce Agency, irc. HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR I P.C. Box 428 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. L 104 Main Street Nortl- Andover, MA 01845 'INSURERS AFFORDING COVERAGE i NAIC i Frank Stewart d/b/a Stewar-Electrical CC PREFERRED MUTUAL INSURANCE 115 Blue,idne Road THE HART70RD GROUP No Andover,MA 018415 ONE BEACON INSURANCE COVERAGE$ THE POLICIES OF INSURANCE L;STFD SELOVV HAVE BEEN ISSUEC TO THE INSURED NAMED ABOVE FOR THE POLICY PERICID INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDIT;ON OF ANY CONTRACT CR OTHER DOCUMENT W;7H RESPECT 70 WHICH THIS CEP71FICAT= MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUC:ES DESCRIBED HEREIN Is SUBJECT TO ALL THE TERNAIS. EXCLUSIONS ANDOND:TiONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY c)AIDCLAWIS. LTA IINSPOI �E --- �Z—U7'EFFECTI POL! YEXF —.RAT��—NF'Q'-I-YNLIMBER DATE iMMIDO I DATE iTVM/DDA`,0 LIMITS A Ge4ERAL LIABILr,Y CPP 0110 58 1 76 1 2 102,12 0 D 6 12J021i2007 I$ 1:00c,000 CONAMERCIALGENEPAL UAE�17` CLA11,43 1',AGE LXj r. 5;0_n C T— &(C-PEcATE 3.000,000 CEVL F:;C-REGAT,E LLMIT ES PE�Ri -T pp'- PRC, 04/1 1'*21-")0 0414 1/"41008 ��jNc4LF C AUTOMOBILE LIABILITY 1EC5545 kLL tYoP4ED AUTO� E T-JLJR', 000t 00c) 1 1 HIRED AIJ-0S 51-111LILT NAIF I rjf)N-0MNHDAUP-'-: szc:c]6nc} 1,000,000 PRC-PERTY AIV'.6(3E Ee nd-,;,t;' 200,000 GARAGE LIABILITY �,U-0 EA ACr-IC)F�F, (,NYAUTO 'A A s 7HIEF-1 ONLY SSIUMBRELLAILIASILIrrY xr I C,E CLAIM5MADE AC,51REGATE 'DEDUC'TiPLE i B WORXER5COMPEN3ATION ANDTVCI'-k�7"TUS 08 IVVEC RH/2343 D6109i2007 D&139/2008 CMR.OYERS'LIASIU7Y EACu ACCIDENT I 50)—00'� )PFICERMEM,EER--X:l UDED? E.1 DISEASE-Ek.EMPLOYEE Is 500000 1' fcs,decnb=unde, S-EC'A-. CHS bolow fff —E, DISEASE-POLICYLImIT IA 500,00 OTHER D2SCRPTIONOF OPERATIONS I LOCATIONS IVERCLESIEXCLUSIONS ADOM SY17NDORSEMENT[SPECIAL PROVISIONS Job Sita: Renovations 106&107 Marblehead St., No An-Clover. MIA CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOV!DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION I Town of Nortn Andover OATSTHEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 1980 OsgooSt NO110E TO THE CERTIFICATE HOLDER NAMED 0 THE LEFT,BUT FAILURE TO 00 So SHALL d North Andover. M 01845 IMPOSE NO OBL13ATION OR.UABILIT��OF AH:"KIND UPON THE INSURER,i-S AGENTS OR, A REPRESENTATIVES, AUTHORIZED REPRESENTATIVE Atn. Building Dept I ACORD 25(2001/09) 0 ACORD CORPORATION 1988