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Home My WebLink AboutBuilding Permit #539 - 1600 OSGOOD STREET 4/14/2009 i I NORTH BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Y Permit NO: J I Date Received �`�Cf Date Issued: ao� ��SSACHUS�� IMPORTANT:Applicant must complete all items on this page LOCATION fs OS oo Pri t PROPERTY OWNER rint MAP NO: PARCEL: ZON DISTRICT: Historic District yes Machine Shop Village yes o 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 C-6-/4:ve Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: 4`ar CzLm,ra. —/1 43�`� ct� I`Oo 0S Identification PI e se T e or Print Clearly) OWNER: Name: ResT4. _Shows fix.?-? Phone:(403)VsN(f +Cac.//sv c Address: T p• 0 1 �o k ��n .S a /� /y � 0 � 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 EST ATED COST BASED ON$125 PER S.F. Total Project Cost:, PY1V� -& � Check No.: Receipt No.: y q y� NOTE: Persons lontracting with unregistered contractors do not have access to the guaranty fund ignature of Agent/Owner Signature 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 to ptic 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 i 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 M4'Os ood 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) ❑ Notified for pickup - Date ................................-----------_._....._................................................_...._...---...........__................................_....._..._..........._................_......................................................._..-----...........................................................--- .......................... .......... ...................... Doc.Building Pernut Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. i 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 P Permit Application P ❑ Certified Surveyedof 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 Locatiolim,:� No. 6-3 ` Date f ^TM TOWN OF NORTH ANDOVER 9 ' Certificate of Occupancy $ �'�s''•'°'tt� MuBuilding/Frame Permit Fee $ wcs � Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # f 2 1 9 i. < . It Building Inspector tIO R T►y To of t over No. o = LAKE dover, Mass., COCHICHEWICK 7,9 A0 ATED `s BOARD OF HEALTH PE M T T Food/Kitchen Septic System • 1001W �� , BUILDING INSPECTOR THIS CERTIFIES THAT..... ...a...............0 .�A��r..................�i/ ........................... Foundation has permission to erect....................................... buildings on /0.01 .... Rough .. ... . .......s. . f/� f �/ Chimney to be occupied m,�1 ........ .S= t.�i ....... I........................................................ provided that a person accepting t s permit 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 CONSTRUCTIO STARTS Rough ............ ......... `• 4,^....................................... 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. � �.10RT1y Town 0 4Andover 0 VO No. - i - dover, Mass., ��1 hoz T () -, LAKE COC MIC ME WICK V A0RArED APS\ i `s BOARD OF HEALTH Food/Kitchen PERM1 T T D Septic System h BUILDING INSPECTOR THIS CERTIFIES THAT..... V!�.. ........... ..... ...... ..................... ........................... Foundation has permission to erect....................................... buildings on ....16Qv # .... Rough to be occupiedNjl�✓ .�....... . S'-,cwt. .......�C4. ...✓................................................. Chimney provided that the person acce tin t s ermit shall in eve respect conform to the terms of the application on file in P P P g P every P 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 CONSTRUCTIO STARTS Rough /P�l+'•`'s t"n..................... 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. Department of Public Safety License to Operate Amusement Devices Mr.Eugene J. Dean,Jr. License#: MA-001-08 (603)474-5424 Issued Date: 3/13/2009 Dean&Flynn Inc., Expiration Date: 2/15/2010 Fiesta Shows Certified Maintenance Mechanic 15 Pine St.,PO Box 460 Wallace Wagemaker Seabrook NH 03874 U.S.I.D. # Device U.S.I.D. # 'Device U.S.I.D. iii'Device 05266 Pharoah's Fury 10439 Zipper 10455 Sea Dragon 09974 Slide 10440 Twister 10458 Haunted House(NM) 09975 Scooter 10441 Surfer(Tip Top) 10460 Flying Bolo 09978 Tilt A Whirl 10442 Zipper 10461 Dragon Wagon 09980 Turtles 10443 Round Up 10462 Berry Go Round 10016 Swinger 10444 Cliff Hanger 10463 Panda 10017 Tornado 10445 Sea Dragon 10464 Elephant 10167 Freakout 10446 Tilt-a-whirl 10465 Boomer's Circus(NM) 10204 Eurobungee 10448 Scooter 10466 Merry Go Round 10224 Wacky Worm 10449 Gondola Wheel 10467 Slide(NM) 10311 Music Fest 10450 Mardi Gras (NM) 10468 Tooterville 10394 Haunted Mansion Dark 10453 Dark Ride-Castle 10469 Earthquake Ride 10400 Cobra 10454 Artie Blast or 10470 Orient Express Friday,March.13.2009 Commissioner of Ptibiic Safety Pagel of 2 A J/ gl-w -60 M Department of Public Safety License to Operate Amusement Devices Mr.Eugene J. Dean,Jr. License#: MA-001-08 (603)474-5424 Issued Date: 3/13/2009 Dean&Flynn Inc., Expiration Date: 2/15/2010 Fiesta Shows Certified Maintenance Mechanic 15 Pine St.,PO Box 460 Wallace Wagemaker Seabrook NH 03874 U.S.I.D. # Device U.S.I.D. # Device U.S.I.D. #Device 10471 Bounce-SR 10655 Lucky Lizzy Funhouse 10473 Convoy Cinema 10656 Grand Carousel Chance 2000/Street Racer 10817 Remix 10473 Street Racer 10819 Traffic Jam 10474 Rockin Tug 1000121 Bounce-CA 10478 Raiders(NM) 1001900 Candy Factory 10479 Crary Bus I001901 Jungle Island 10480 Convoy I002406 Atlantis 10482 Slide(NM) 10486 Umbrella Dune 10487 Gravitron 10488 Dizzy Dragon 10489 Crary Bus 10490 Hampton Combo Friday,March 13,2009 Commissioner of Public Safety Page 2 of 2 Mar 11 2009 1 : 24PM ALLIED SPECIALTY IMSURAMC 7273675695 P. 1 ACDRDCERTIFICATE O LIABILITY INSURANCE arl,aooa P� Allied Ity Insurance,Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INPORMATIO 1046, . ONLY AND CONFERS NO RIGHTS UPON THE CERnFICA1 HOLDER. 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