Loading...
HomeMy WebLinkAboutBuilding Permit #582-15 - 1600 OSGOOD STREET 5/1/2018 BUILDING PERMIT of t%ORTHI .1 6�•LE D.�bt �O TOWN OF NORTH ANDOVER ".:6 ` APPLICATION FOR PLAN EXAMINATION - ~ Permit No#: ` Date Received Qq cxic ew.c• ��SSACHlIS�t�� Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATTI:ON�,; FF Print` iPR®PER,TY 01NNER _ - _ { Pnnt 100 Year Struc u e 'l-�rz yes no: w �.. . wu MAPNING`DISTRICT �Histon�±District es I Machrne.'Sho Villa a es �.l? � g� �Y�� ono; 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 I] Septic EI-6,lh ❑EFloodplainv _ . % _ ❑Wetlands 0 Watershed [)istnct . r ❑�Wate;r/�Sewer�_____ - DESCRIPTION OF WORK TO BE PERFORMED: I 'ri ation- Please Type or Print Clearly OWNER: Nam Phone: Address: 'Contractor Name �� Adtlress ?� Supervsgr's C�onstructionLicerse� =_.,Exp }Date' _ + f H®meN'IrnpQ0�emento License -_ ._ _ -Exp ate: _ ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED;COSTBASED ON$125.00 PER S.F. Total Project Cost: $ � FEE: $ /Z2 Check No.: �w 5�2 Receipt No.: NOTE: Persons contracting with unregistered contractors do not have°'accessto the guarantyfund of'Agent/Owner / � - - r tlgnature of coritractor .. _`' Plans Submitted ❑ Plans Waived 0 Certified Plot Plan ❑ Stamped Plans ❑ '[—TyPF OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody 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 Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Signature COMMENTS r 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 s,RREAJEPAR4TMENT Tempi®umpster gn site 'Locatetl�at 1243MamStreet _ `� ` � � � E - ff 1 u ire Depar�tmentsignature/"date r _. -_ . IrkN 9 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 Call Email I Date _ Time Contact Name I �I Doc.Building Permit Revised 2014 I Building Department i 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 o 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 permitsrequire sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application o Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses o Copy Of Contract ❑ Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) o 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) o Building Permit Application ❑ 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 o 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:Building Permit Revised 2014 4 Location No. Date f J . - TOWN OF NORTH ANDOVER • � �v Certificate of Occupancy $ Building/Frame Permit Fee $ �� c Foundation Permit Fee $ Other Permit Fee $ TOTAL Check# x17 Building Inspector cubicle connection inc. Estimate 127 Conant Street -- Danvers Ma.01923 Date Estimate# 1/5/2015 1087 Name/Address Strolid Inc. 1600 Osgood St. North andover Ma.01845 Project Description Qty Rate Total Estimate For CCI to build 60 Call stations 5,500.00 5,500.00 Total $5,500.00 i CWC DATE(MM/DD/YY A�Ro CERTIFICATE OF LIABILITY INSURANCE 8054 11/12/2014 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PAYCHEX INSURANCE AGENCY INC (AIIC,,No.Eid): (Z' No): (888) 443-6112 i 210705 P: F: (888) 443-6112 ADDRESS: PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAICN SAN ANTONIO TX 78265 INSURERA: Sentinel Ins Co LTD INSURED INSURER B: Twin City Fire Ins CO INSURER C: CUBICLE CONNECTIONS INC INSURER D: 127 CONANT ST INSURER E: DANVERS MA 01923 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR I TTPEOFINSUR.INCE ADDLSUER POLICTNUMBER �WVD ��EFF POIJCYEXP LLW77S IAr'SRCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1, 000, 000 CLAIMS-MADE OCCUR DAMAGE S(RENTED $1, 000, 000 PREMISES(Ea occurrence) _ A X General Liab 76 SBU IV2443 07/28/2014 07/28/2015 MED EXP(Any one person) $10, 000 PERSONAL&ADV INJURY $1, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE k2,000, 000 POLICYJECT PRO-❑LOC ` PRODUCTS-COMPIOP AGG62,000, 000 OTHER: ' $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO BODILY INJURY(Per person) ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Peraaadent) $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $1, 000, 000 A EXCESS LIAB CLAIMS-MADE 76 SBU IV2443 07/28/2014 07/28/2015 AGGREGATE $1, 000, 000 DED X RETENTION$10,000 WORKERS COMPENSA TION X PER OTH- ANDEMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $1, 000, 000 OFFICER/MEMBEREXCLUDED7 B (Mandatory In NH) NIA 76 WEG EU1185 07/30/2014 07/30/2015 E.L.DISEASE.EA EMPLOYEE 11, 000, 000 If yes,describe under E.L.DISEASE-POLICY LIMIT 11, 000, 000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Panel Claw AUTHORIZED REPRESENTATIVE 4 1600 OSGOOD ST �� NORTH ANDOVER, MA 01845 ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD � �ORTF� Town of ,rAndover p - 10 No. - ,� o h over, Mass, 5 COCMIG MlWKR ��� x.95 R�reo �Pa��S ll BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT ..................4��..... .. . ........ ....✓.`�,✓�.��'.��G:F...:............................ ...`.... BUILDING INSPECTOR �.. �� U' pp (�/ �� Foundation has permission to erect .......................... buildings on .........................S�y—............. ..�.......�........ Rough n �a to be occupied as ......... .................: r...:..........:: y .............................................. ..�.�...... .:................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application Final on file in 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 CONSTRUCTI ARTS Rough Service ..f:.........'�..................... ' Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. Smoke Det.