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Home My WebLink AboutBuilding Permit #51 - 108 MAIN STREET 7/17/2009 BUILDING PERMIT Olt OORTH q TOWN OF NORTH ANDOVER 3? 4 APPLICATION FOR PLAN EXAMINATION 'A Permit NO: 6_ Date Received Cl Date Issued: /7 �S SACHUS�� I PORTANT:Applicant must complete all items on this page LOCATION.-,/—d P nt' PROPERTY OWNER Print MAP N0: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: dentifica ion ease Type or Print Clearly) C-' OWNER: Name: I/�� J (• I sf. - Phone: 97T—(fid F� Address: Ab. A140\)62_11 62_1 R,+U jy-v� CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ FEE: $_ '3�0--� Check No.: ��7..3 Receipt No.: ,?- 2 2- NOTE: NOTE: Persons contracting, itliunref istered contractors do not have access to the guaranty fund Signature of Agent/Owne ignature of contractor 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 CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature 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 - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS 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.$100-$1000 fine NOTES and DATA— (For department use S ❑ Notified for pickup - Date Doc.Building Permit Revised 2009 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 ❑ 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:Building Permit Revised 2008 Location��d7 5t- No. <7f Date NORTh TOWN OF NORTH ANDOVER F 9 ' Certificate of Occupancy $ s�,;�,N;s t� Building/Frame Permit Fee $ 30 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # /� f 222 ,- 5 Wouilding Inspector F NORTH 0 0 R over 1 ° _ � ^ No. ..� ,�u.A.. Wiz^ v 7117/0 0 o dover, Mass.LAIKE , co MIC ME WICK 7� 0RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System �J f BUILDING INSPECTOR THIS CERTIFIES THAT �/4j. :/.Y /5.. .. . / /.. Foundation has permission to erect........................................ buildings on ......../0..�........0� , ......... .. .............................. Rough to be occupied as............................... .. .. . . .....:....,,�•.C' / ... ,.1 ...�,.1. ....... Chimney Ch' e provided that the person accepting t is permit sh I in every respect conform to the terms of e a icatio�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 CONSTRUCTION TARTS Rough Service ICBMI)ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR E 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. : } 06/01/2009 14:10 603-964-1484 ALLEGIANT MGMT CORP PAGE 02 A , CERTIFICATE Of; f�fAE�ILtTI(ffVSURAfVC OA7G(M 1al�oos Frank Ventlto HIS CE ATE 15 ISSUED AS A iNAT7 INFORAigTIO ONLY AND CONFERS NO RIGM UPON THE CERTIFICATE 52 ABTA,Inc. HATrERR'FIEHCOVERAGE AF 4Rdnun nTHE�POLicies BELOCW.. 529 Main Stmt;suite 806 Boston,MA 02129 INS trRm WSURIERS AFFORDWo COVERAGE NAIL# Allegiant Management Corp, Neutium zudch-American Insurance Company 300 Latayoue Fid. NSURIEft Rye,NH W$7o•000 INSURER D: COVERAGES NsuRER E: -- ANY RE�QUIREMENTSUTERM OR QONDfITON OF ANY CTED BELOW HAVE ONI RACT ORSUED aOTHER DINSURED OCUMENT WITH RESP CT To WyjCH THIS CERT RO TE Md BE S IED TANDING MAY PERTAIN,THE INSURANCE'AFMIAD l)BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO A4L THE TERMS,EXCLUSIONS AND CONDmONs POLICIES,AGGREGATE LIMBS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS- OP SUCH I PWx7YNDIY@ER POLI(:Y GENMALUABLnb LAM EACHCCOURRRNCE i COMMERCIAL 0@NERAL LMBILnY txAWMADE 7 OfXUR s MED aP ,„o on) j PERSCNN,AADVtNdURY j (3CdNERAIAOCNRFQATE g C,EN1A00pEQATELIMRAPPLIESPER: POLICY MOT, D PRODUM-OP/WAOd $ Lou OM _ AMOROMF UAB UTY ANY AUTO OOMBINEb SIMILE LIMB j tEe eDetrAT�l ALL OMED AUTOS ECHEMEDAUTCP ODLYODURY porgoml 1 HIREDAUTOG NON-"ED AUTOa ECDILY nIrJURY tPmaeeidenq S PRROnPvEuRRTYYq AMAGe $ OARAOE L"IITY ANY AUTO AUTO ONLY-EAA001DEW j OTHERTHAN EAACC 5 AUTCONLY: AG0 $ w7tCbSeAlMaRE1.Ia4LYte1L7iT EACttCCgd�ENOE R OCCUR CIAM)SMADE AWREGATE 5 •� DEDUCTIVE S E j S waTttQTect�oNSATtoN ANE X EMMAYERS'Luu� RY OT A M�ErcMm ecLnmE WG 50.90.735-00 10118/2008 11/01/2009 E.L.EACHAC0I0t1T s _ 1,000,000 ryyeadffl E,L R ft-EAEMKOYE b 1,0w,ow Sr+EGI PROVE blow E1.WASE-PC IDYLIMIT S t,�O,000 4TNRR Location Coverage Period. 10/18/2008 11/0112009 CBrtMcatat 08NH00278mos Clleni#: 821 t#E�OAIPTiOR QF CPGAATIONaJLOCATrI)NSlVERICLEBt OCCLD910Ns AODE~fl 6YENODR9BUBrr i�Cig6 pADVIEICNg Covorage Is provided for enty North Shore Aarttal,Inc,dba:Events for Rant Biose emPIDyeom leaacd to 464 Loweil St W not atl Mftaotors o,: Peabody,MA 01960 C RTIFICATE HOLDER CANCELLA110H SOMW ANY OF THE ABOVE DESCIRIMPOUCHES gECu+tS:n.MRMVMTHE GMPIKATtvN DATE THEREOF,TM ritSUM0 INOMM ML ENNAVOR TO MNL SO DAYa WRn'M dba:Events for Rent North Shore Rent Inc, N911Ce 10 1H CE MIRCATE"GUI=NAIIED TO THE LEFT,RUT PAIWRE TO DO SD 0HALL 464 Lowell St NI CM h0 ONLIOATtON oe UARILRY OF ANY KIFID UPON TN5 pNnurtan,RS AGWga on Peabody.MA 01960 IRIFMi MITVEB. AUTHOR=RFlFRE VffATIVC ACCRA 25(2009/08) 0 ACORD CBRPOfIATER 19--i 98 610537 6/5/2009 1:08:49 PM PAGE Z/UUj rax atrzvGz lin :41 242 9900099 AC RD. CERTIFICATE OF LIABILITY INSURANCE 005 o'er' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION USI Rental Specialties ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O.Box 53310 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Irvine,CA 92619 800 854.3298 INSURERS AFFORDING COVERAGE INSURED INSURER : St Paul Fire and Marine Insurance Co North Shore Rental,Inc. INSURER B: dba:Events For Rent INSURER c: 464 Lowell Street INSURER 0: Peabody,MA 01960 INSURER E COVERAGES 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 TD WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LIMBS TYPE OF INSURANCE POLICY NUMBER ATE DATE M A GENERAL LIABILITY CK00220071 04/01109 04101/10 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Anyone Fre) $100000 CLAIMS MADE Fx�OCCUR MED EXP(Any one pennon) $5.000 PERSONAL B ADV INJURY 1$1,000,000 GENERAL AGGREGATE s2,000.000 GEN'L AGGREGATE LIM ITAPPLIES PER: PRODUCTS-COMPIOPAGG $1,000,000 X POLICY PRO- LOC A AUTOMOBILE LIABILITY MA00200332 04101/09 04/01110 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Ea accident) ALL OWNED AUTOS BODILYINJURY $ SCHEDULED AUTOS 1 (Per pe—) HIRED AUTOS i BODILY INJURY $ (Per aocident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHERTHAN EA ACC $ AUTO ONLY: AGG $ A ExcESSLIABILITY 502XA8914 04101109 04101110 EACHOCCURRENCE s1 000 000 X OCCUR CLAIMS MADE AGGREGATE S1,000,000 $ DEDUCTIBLE $ X RETENTION $10000 OTH- $ WC WORKERS COMPENSATION COMPENSATION AND EMPLOYERS'LIABILITY E—EACH ACCIDENT $ E.L.DISEASE-EA EMPLOYEE$ El.DISEASE-POLICY LIMIT I$ A OTHER CK00220071 04101/09 04/01/10 quipment Floater $185,000 Limit tial Form $Z500 Deductible DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES=CLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS This certificate is issued as a matter of proof only.*Except 10 days notice of cancellation for non-payment. CERTIFICATE HOLDER ADDITIONAL INSURED;INSURER LETTER: CANCELLATION SHOULD ANYOFTHEABOVE DESCRIBED POLICIESBECANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TOMAR3()!—DAyswRrrTEN NOTICETOTHE CERTIFICATE HOLDERNAMEDTOTHELEFT,BUTFAILURE TODOSOSHALL IMPOSE NO OB LIGATION OR LIABILITY OF ANY KIND UPON THE INSURE R,ITS AGENTS OR REPRESENTATIVES. ALIT ORIZEP REPRESENTATIVE ACORD 25-5(7197)1 of 2 #S38732561M3873253 AXLJG 0 ACORD CORPORATION 1988 E PL Prj-L3 rr-3P i 1 M P O RTA N T DOCUMENT 5 Certificate of FIa Res!sta ee 5 S REGISTRATION uc�f ISSUED BY 5 Date of Manufacture 5 APPLICATION CHR 5 ,i 04/17/03 NUMBER s INDUSTRIE INC. 5 57`Jll (y<s J EVANSVILLE, INDIANA 47725 Order Number Dj 5 F140.1 MANUFACTURERS OF THE FINISHED 366381 fj TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated S 5 (or are inherently noninflammable) and were supplied to: 5 5 293200 S 5 FOR RST NT INC#13528-8 4644 LOWELS SW PEABODY MA 019602741 5 5 S 5 S 5 5 5 Certification is hereby made that: S 5 The articles described on this Certificate have been treated with a flame_retardant approved 5 5 chemical and that the application of said chemical was done in conformance with California 5 5 Fire Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. S 5 The method of the FR chemical application is: 5 5 Serial # 8047300(1) S 5 Description of item certified: 5 NAVITRAC MID 40WX20 SNY W W 5 S 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric 5 SSNYDER MFG NEW PHILADELPHIA OH Signed: �� 5 5 Name of Applicator of Flame Resistant Finish TENT DEPARTMENT-ANCHOR INDUSTRIES INC. 5 rJ�r�rPr��1�rJ��PrPrJ�r�rJ�rJ�rJ�r_fr Pcl�Pr�r�rlrl�PrE;L.2 J�r1�P�fr��P�PrJ��Pr!r�r�rJ�cPr��PcP rlr�r��Pr_trJ�rJflJ��Pr�rJ�r��Pr�r�rJ�cP�PrJ�r f�P�P�PrJ��PrJ��PtPcP " RTA N T DOCUMENT 5 Cervi S 5 f�cat�e v� �larrte l�es�s�ax?ce 5 1 REGISTRATION ISSUED BY S utiF Date of Manufacture 5 S APPLICATION a CN S 5 04/17/03 NUMBER = INOUSTRIE INC.® 5 Order OrdNumber C EVANSVILLE, INDIANA 47725 5 5 F140.1 cM MANUFACTURERS OF THE FINISHED 366381 5 Cj TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated 5 S (or are inherently noninflammable) and were supplied to:293200 5 5 EVENTS FOR RENT INC#13528-8 S 5 464 LOWELL ST S 5 W PEABODY MA 019602741 S 5 5 5 5 5 5 5SS Certification is hereby made that: 5 5 The articles described on this Certificate have been treated with a flame-retardant approved S 5 chemical and that the application of said chemical was done in conformance with California S 5 Fire Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. S 5 The method of the FR chemical application is: 5 5 Serial # 8047100(2) 5 5 5 5 Description of item certified: 5 5 NAVITRAC MID 40WX10 SNY W W 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric S 5 SNYDER MFG NEW PHILADELPHIA OH Signed: 5 Name of Applicator of Flame Resistant Finish TENT DEPARTMENT-ANCHOR INDUSTRIES INC. 5 D r1r�rJ�rJ��Pr1cPr�rJ'�Pr�rJ�rJ�rJ��P�PrJ�rJ��Pct�P�Pr�rJ�cJ�rJ�cPr�cP�PrJ�rJ�rJ�rJ��Pr��PrJ'rJ�rJ�r�r.t� s=P�rJr�c.l�rJ�cl�P�PrJ�cJ�PrJ�tPc.nr.P�.fcPrJ�rJ�rJ�ctr�c.fr�cJ�r�cJ�r� �