HomeMy WebLinkAboutBuilding Permit #329 - 1469 SALEM STREET 10/30/2007 BUILDING PERMITof No DT" A
TOWN OF NORTH ANDOVER 3? '`y, . ,b•6 oL
APPLICATION FOR PLAN EXAMINATION
Permit NO: Date Received
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Date Issued: /e 0 07
IMPORTANT:Applicant must complete all items on this page
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TYPE OF IMPROVEMENT PROPOSED USE
Residential Non-Residential
New Building (One famil
Addition _ Two or more family Industrial
Alteration No. of units: Commercial
Repair, replacement Assessory Bldg Others:
Demolition Other
Septic° "}5L�11�3ti °£' '{ Joocila7rxWe#lamds XNP
V11a#ersetI3�str�ct
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7ta#er/Sewer,. t „�* � t ,
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DESCRIPTION OF.11VORK TO BE PREFORMED:
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Identification Please Type or Print Clearly)
OWNER: Name: L6rr �e CL Phone: �S 7�v
Address:
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C011�1TRAGT<OR QNare e r t
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Hoi""`Am-rov' rn—License J. w L" 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: $ 973.- FEE:
Check No.: I byq Receipt No.: 7 y
NOTE: Persons contracting with unregistered contractors do not have access to the guaran fund
Signature of:Agent/Owner - - a�nature of:con#ractor
Plans Submitted Plans Waived Certified Plot Plan Stamped Plans
TYPE OF SEWERAGE DISPOSAL
Public Sewer Tanning/Massage/Body Art Swimming Pools
Well Tobacco Sales l 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
it 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 Driveway Permit
Located at 384 Osgood Street
FIRE DEPARTMENT Ternp Dunpsteron site fires# no
Located at 124 MainStreet
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Fare Department sigraaturedate
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;COMMENTS r
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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)
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❑, Notified for pickup - -Date
Doc.Building Permit Revised 2007
,
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
o 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
o 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
Q
New Construction (Single and Two Family)
❑ Building Permit Application
o Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
o 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 thea peal period is over. The applicant must then et this recorded at the Regi
P P PP g Registry of Deeds. One copy and proof of recording
must be submitted with the building application
Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07
Revised 2.2007
Location
Y
No. %'� Date
NORTH TOWN OF NORTH ANDOVER
} Certificate of Occupancy $
bis' °'•tA Building/Frame Permit Fee $ �7
s4CMU5E -
Foundation Permit Fee $
Other Permit Fee. $
TOTAL $ �-
Check # /{/o
204
uilding Inspector.
----- —_
I
i -— All Types of Home Improvement
1.14 Hale Street, Suite 204
Haverhill,MA 01830 'a_r,� _
I Haverhill,MA: (978)372-4088 Boston,MA: :d r
(617)423-3559
I I Andover,MA: (978)475-3723 Nashua,NH`. (603)595-2272
i Woburn,MA: ) (603)433-1811 '
(781 937-4212 Portsmouth,NH:
Natick,MA: (508)653-2200 Manchester,NH: (603)666-5502 + y
www.jnrgtltters.com Fax:
(978)372-0360
Toll Free Nationwide: (800)966-9238
PROPOSAL SUBMITTED TO r n' �yl� PHONE 978-2
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�'—i— (.�Li1:11S �d ��G V�fT" ��i-'58-�1s�� DATE
STREET JOB NAME
CITY STATE and ZIP CODE JOB LOCATION
t ARCHITECT' JOB PHONE
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e PrO13 5e hereby to furnish materi d labor-complete in accordance with s I 'cations below, for the sum of: }�
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Payme o be made s follows:„
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Authorized �~- Note:this proposal may be q
i Signature withdrawn by us if not accepted within l days.
We hereby submit specifications and estimates for. SUI E'r `�`CS e.Ut
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BE A 30 N'LAR ARCI III~:Cg'URAL DESIGNER STALE. (CUSTOXIER WILL HAVE THE CHOICE OF 11[iE
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00/03/20015:51 FAX . 978 532 2217 0 K McCARTHY ImVVq/vVa
Cllent#f:1 716 JNRGU
DATE(MMMDmYY)
;�i CORD, CERTIFICATE OF LIABILITY INSURANCE 0e103r07
P R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
1�.KI{.McCarthyMfns.Agcy.Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
10 Centennial Drive HOLDER,THIS CERTIFICATE DOES,.NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Peabody,MA 01960
978 532-5445 INSURERS AFFORDING COVERAGE NAIL#
INSURED INSURER;! ProBuilders Speciality Insurance Co, 33618
JNR Gutters,Inc. INSURER 0: Safety Indemnity.Insurance Co.
39•d0 Lancaster Street INSURER O.
Haverhill,MA 01830
INSURER D,
INSURER Et
COVERAGES
THE POLICIES OF INioRANCELISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD.INDICATEO.NOTWITHSTANDING
ANY.REQUIREMENT;TERM:OR.CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH.THIS CERTIFICATE.MAY Eli ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE 13OUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OP SUCH
POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I P EFFEGTI E P LI YEXPIRA N LIMBS
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TYPE GR INSURANCE POLICYriUYBER MM1DD
A GENERALLIAE'IuTY 06!21107 06/21108 LACHOCCURRENCE 81,090,00-
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0X COMMERCIAL.GENERAL LIABILITY DAMAGE.TO RENTED 1150,000
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X RI PERSONAL LADV INJUAY 111 ODO 000
GENErKAGGREGATE 12,000,000
GEWL AGGREGATE LIMIT APPLIES PFR: PRODUCTS•COMWOP AGO 31,000,000
POLICY PRO L00
B AUTOMOBIL!LIABILITY 3945441 06121107 06/21109 COMBINED SINGLE LIMIT
ANY AUTO (Eaecoldent) $1,000,000
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GARAGE LIABILITY AUTO ONLY•EA ACCIDENT S
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0E86RIPTION OF OPERATIONS!LOCATIONS I VEHICL98I EXCLUSIONS ADDED BY.ENDORSEMENT.I SPECIAL PROVISIONS
Evidence of Coverage
CERTIFICATE H0kQER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 6E.CANCELLED BEFORE THE EXPIRATION
Evidence of Coverage DATE THEREOF,THE ISEUINGINSURERNfiLLENDEAVOR TOMAIL _i(L DAYSWRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE MOD SO SNA"
IMPOSE NO OBLIGATION OR LA1BKM OF ANY KIND UPON THE INSURER,ITS A0ENT6 OR
REPRESENTATIVE
A TN0RIZ0 REPMINTAT IYE
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ACORD 25(2001108)1 of 2 #34921 $MINI 0 ACORD CORPORATION 1998
Me 09/20/2007 10:40 FAX 978 531 4857 B K McCARTHY 9001/001
P.20.2007_ 9s�5AM AIM MUTUAL NO.e06 -P,li1
CERTMCATE OF I"NKMANCI i ISSUE DATE /20/2007 ' 3
P� AUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND
B K McCarthy Insurance Agency CONFERS NO RTQHT9 UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE
DOES NOT AMEND,EXTEND OR ALTER THE COVM?AGE AFFORD14D AY THE
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THIS IS TO CERTIFY THAT TRB POLICIES OF INSURANCE LTSTED BEWW HAVE BEM RUED TO THE INSURED NAMED ABOVE FOR WE POLICY
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OLDER NAMED TO T=IMT,BUT FA>T.iJXII TO M61t,SUCH N=CE SHALL IMPOSP NO OELMATTON
OR LJAtlMT OF ANY YJND UPON TEL COMPANY.US AGENTS OR RBPR E;rjTATTVm,
38-"LANCASTIM STREET
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HA'VRRETIL4 NIA 01831
01 RL7A01'JRII nY7flnncvA7Tn TR/D
N0RT1y
OIWM of Andover
No. 3 61 ?
C,o N- o l dower, Mass.,
COCHICHEWICK
AERATED PPS\ ��
`S BOARD OF HEALTH
PERMI �i T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THISCERTIFIES THAT......... .............. .f'Jw..F........................................................................................................ Foundation
s 6 y seleg� s�
haspermission to erect........................................ buildings on .................. ........................................................................... Rough
to be occupied as....................:.. �'�,<�.... . G`s..... �...:.................... .................................. Chimney
. . ...... .....................
provided#hat the person accepting this perm' 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 CONSTRUCTION TARTS Rough
....... .... ..... ...... .. Service
...................
.... . . ...... ....:.. ........ ......... ..
BUILDING INSP R
Final
Occupancy Permit Required to Ocmpy Building.,,,. GAS INSPECTOR
Display Rough
a in a Conspicuous .Place on the Premises �- Do Not Remove
p y P 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.