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Home My WebLink AboutBuilding Permit #617 - 1160 GREAT POND ROAD 4/22/2008 BUILDING PERMITo* 00 oT" qti TOWN OF NORTH ANDOVER „6*° oL APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received6a �DAA7tD ;/0 2k �SSACHUS�� Date Issued: IMPORTANT: Applicant must complete.all items on this page LOCATION //l0 4 4'lze=.yl- !2".I-d -0.0 G Oti1 C' CG Print PROPERTY OWNER 04-00/cS' 'e,6x,r) 4— Print MAP NO: PARCEL: ZONING DISTRICT: Historic District -yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building family Addition yIf-cha(3 ��, Two r more family Industrial Alteration i�s1 No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer ` 9 � DESCRIPTION OF WORK TO BE PREFORMED: 1A)5J,1 LL 'CZE �Gyy /�f'L.d 4—All 1N /' 04eOAe!I Cl' AVS e-L. Identification Please Type or Print Clearly) OWNER: Name: le'lovx r4. ��1�� Phone: w143� 35�s- 217K Address: /8 %c:/%a �d�S�•�� /. .030sl CONTRACTOR Name: �.t7TGo r/ IS Phone: w1P3- J-- 2F 7x +1 Address: Ig AAf1g1e_1^,V / v 56. a. a Supervisor's Construction License: Exp. Date: Home Improvement License: Exp.-, Date: 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: $ d FEE: $ l0?0 Check No.: / 3 1 Receipt No.: q/o�� NOTE: Persons contracting with unregistered contractors do not have acce t eguaran fund Signature of Agent/Owner _ Signature of contract r 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:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 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 nog Located at 124 Main Street Fire Department signatureldate 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 C.0 / j b'2 ❑ Notified for pickup - Date Doe.Building Pennit Revised 2008 Location No. Date ' Z Z .,P/— TOWN °/— f TOWN OF NORTH ANDOVER 3 • OL � 9 ' Certificate of Occupancy $ Building/Frame Permit Fee $ A Foundation Permit Fee $ Other Permit Fee $. TOTAL $ Check # / 2 10 9 6 Building Inspector J U u 1� + VSB42 " n CD OD J a Master Bath 2 In nN w 0)rn N V •- Y m m VSB36 OD0 ori m 2nd Floor Bath A B18R O 4D�18rlSHW SB3 / 618E LRIE J RW361224 VS30B W18 OR W3012 W24 0� O O I 1 st Floor Bath 108" 108" 75" 66" 75" (/nJ(— � 216 All dimensions_size designations given are20 2('ti p`� This is an original design and must not be Designed: 1/4/2008 subject to verification on job site and TECHNOLOGIES f released or copied unless applicable fee Printed:3/18/2008 adjustment to fit job conditions. has been paid or job order placed. Brooksfront I All Drawing#: ] NORTfy T014M of _ Andover No. - LAK odover, Mass., I� COCHICHEWICK y 7qs RATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.......... IS •j .�' ........tsio— ,� Lr BUILDING INSPECTOR .......... Foundation has permission to erect....................441*w. .. ....... buildings on .//46.40.....l�f�! .. ........... ... . Rough Chimney to be occupied as ........X�Gjthis .....i�'.................................................................................................................... y provided that the erson acpermit 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 A2 40 •�� PERMU EXPIRES IN 6 MONTHS 1. ELECTRICAL INSPECTOR UNLESS CONSTRU S 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. 155;" a, 41" 51;" 36" 221." 25a" 89;"— 4 ;" W4230 ✓ --_ - -- 1830F3 O I J N B45 tl S 6 B21 R F3 J P y" R JV. 3.3 / r J 84LR1R O O 1158424U N N i S30 W3015Rw331524 � J / I , W2130R W3018,/ LM130L t` 155;" c� )Od All dimensions_size designations given are2O��'��j This is an original design and must not be Designed: 1/4/2008 subject to verification on job site and TECHNOLOGIES[f® released or copied unless applicable fee Printed:3/18/2008 adjustment to fit job conditions. has been paid or job order placed. Brooksback All Drawing#: 1 M` ail Sla ae �> ISSUE DATE 4/14/08 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY PRODUCER AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS FOY INSURANCE GROUP LLC CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE 350 MAIN STREET AFFORDED BY THE POLICIES BELOW. NASHUA,NH 03060 COMPANIES AFFORDING COVERAGE COMPANY A TRAVELERS PROPERTY CASUALTY CO OF LETTER AMERICA COMPANY B LETTER INSURED COMPANY C LEDOUX,NORBERT JR LETTER DBA PATCO CABINETS LETTER D 18 PATRICIA DRIVE COMPANY E LE HUDSON,NH 03051 THIS IS TO CERTIFY THAT 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 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 AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO TYPE OF INSURANCE POLICY NUMBER POLICY POLICY LIMITS LTR EFFECTIVE DATE EXPIRATION DATE D/YY) D/YY GENERAL LIABILITY GENERAL AGGREGATE $ 0 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ 0 CLAIMS MADE 0 OCCUR. PERSONAL&ADV.INJURY $ 11 OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $ 0 FIRE DAMAGE(Any One Fire) $ MED.EXPENSE(Any one person $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 0 ANY AUTO 0 ALL OWNED AUTOS BODILY INJURY $ (Per Person) 0 SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per Accident) 0 NON-OWNED AUTOS GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY 0 UMBRELLA FORM EACH OCCURRENCE $ 0 OTHER THAN UMBRELLA FORM AGGREGATE $ TO BE 04/09/2008 04/09/2009 DETERMINED STATUTORY LIMITS WORKERS'COMPENSATION EACH ACCIDENT $100,000 A AND EMPLOYER'S LIABILITY DISEASE-POLICY LIMIT $500,000 The Sole Proprietor/Partner(s)/Executive Officers are DISEASE-EACH EMPLOYEE $100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE EGE_ HQb1D.. BROOKS SCHOOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ATTN:NORMAND GRENIER - 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 1160 GREAT POND ROAD BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES NORTH ANDOVER,MA 01845 AUTHORIZED REPRESENTATIVE ACC,^QIt125 719f1 ° , O r�tAeIP®ITION99Q,% 3