Loading...
HomeMy WebLinkAboutBuilding Permit #255-13 - 18 JOHNSON STREET 10/1/2012 O Nt.D 1 gti0 RTH BUILDING PERMIT c? h}.•., 6 0� TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION T ' h P O �A O 7 Permit NO: — Date Received 74�C AT, SSA It Date Issued: �d ` -L IMPORTANT:Applicant must complete all items on this page LOCATION / LcifSo ,� de Prin PROPERTY OWNER' �14 �L� !,S � D/�' ✓� K pl/Pl/L . rint 'MAP NO: t✓P PARCEL: 4VO ZONING DISTRICT;�- 3^Historic District no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building C.02!_!Mily Addition Two or more family ,//// Industrial Alteration No. of units: .1N 66z11:f Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION O WORKTO BE,J, 'REFO MED: _ If log S�le�?' eocL/1/�GMsla%e, �e� 1�,er«L �Gv..,�s;�s. 1(i'/rley. Neu.��A • Ide tification Plf ase Type or Print Clearly) OWNER: Name: 7—,&,4, PIZ/U. Phone: '1(oA0 Address: 177 i CONTRACTOR Name: s�r�,� �`� C. !oo p Phone: -6'0 Address: 62.�! ��� �`G#46-1/ Supervisor's Construction License. Cs 7.S3 0�., ,'Exp. Date:. /.aA/4a,0 � Home Improvement License: .: Exp. Date: ARCHITECT/ENGINEERS 4"dWe/.1 &096:P10A1 Phone: Address: 6?aoP6e )�Wv1 . � 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: $ ttEV cvQ FEE: $ Check No.: CReceipt No.: NOTE: Persons contracting with unregistered contracWrs do not have access to the guaranty fund Signature of Agent/Owne �igna�ture of contra 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) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 BuildingDepartment 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 Location No. X? Date • ' TOWN OF NORTH ANDOVER • e - Certificate of Occupancy $ n ftlli Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check# 25770 Building Inspector Location � No.255- /,3 Date /2 s 7 • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ a� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $_ Check 4ey63 26030 Building Inspector OMO.TM�h ,SShC NU5E CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 255-13 on 10/1/2012 Date: December 11, 2012 THIS CERTIFIES THAT THE BUILDING LOCATED ON 18 Johnson Street MAY BE OCCUPIED AS an apartment—Unit #18 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Benjamin C. Osgood 69 Old Village Lane North Andover,MA 01845 Building Inspector Fee: $100.00 Receipt: 26030 Check :8483 r1 . ., NORTIy 1 _ c . . ve" ** o - �► No. % LAK, h ver, Mass, r� COCHICKl WICK y1. �d ADRATED - S U ; BOARD OF HEALTH PERMI'T T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ..........:�:':.:. .... �.:.:.:... V V� Foundation rr' has permission to erect .......................... buildings on ...:. ..... .::.:.......................... ...................... R �.� ought ... to be occupied as ..:................, . :....:....:.....:...........::.:....:......p.....:..:::::.......:.............. .................:............ Chimney provided that the person accepting this permit shall In every respect conform to the terms of the application Final �� " '�' ° Lichon 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final LO PERMIT Q� PERMIT EXPIRES IN 6 MONTHS ELECTRICAL I SPECTOR UNLESS CONSTRUCTION STARTS _;;:r , . Rough - Service- ...............................✓.:,.`.,,: ....................................... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough !!✓%% Display in a Conspicuous Place on the Premises - Do Not Remove Fina' No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No.`s Smoke Det.!!} SEE REVERSE SIDE 1 rNORTIf.I . _ 1 w . ver No. A*Ah ver, Mass, COCHICK.W,CK �1 A�RgtEID) ►P�,�,�y S u BOARD OF HEALTH Food/Kitchen PERMIT T L D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .........:: .................. Foundation has permission to erect .......................... buildings on ....'. ................................. ............. .... ....... ' Rough` to be occupied as .:::.:::.:.:.:. .......`.. ...............:............................................................ 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 Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL I SPECTOR UNLESS CONSTRUCTION STARTS Rough ., Service- �G � -2, ...............................✓.:..:...:...:.. ..:......:..::.................... Final �.-.�— BUILDING INSPECTOR r GAS INSPECTOR px Occupancy Permit Required to Occupy Building Rough Final ��BU 0 Display in a Conspicuous Place on the Premises Do Not Remove o e No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. f�Z— �. u� SEE REVERSE SIDE Enter construction cost for fee cal - North Andover Fee Ca1CUlaflon Construction Cost $ 50,000.00 m $ - $ 600.00 Plumbing Fee $ 75.00 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 75.00 Total fees collected $ 850.00 18 Johnson Street 255-13 on 10/1/12 Reconstruction of unit 18 Sheet rock, electrical, plumbing, kitchen and new bath r , F NORTH .0 6 tt . " ve. _ 0 ..... .: No. h ver, Mass, �J COCNICNeWICK y1 p�R�1TIE D ►PP,�'Ly , - S V BOARD OF HEALTH Food/Kitchen Septic System PERMIT T LD THIS CERTIFIES THAT r�` 1�qureo� BUILDING INSPECTOR �',+ ,� Foundation has permission to erect .......................... buildings on ..��.. ..............:............. .................................... /�IJG lJi�! ( � ....l ��G ......................... �7icG oL ..�/. Chimney tobe occupied as Fera.✓.. ... .... �......:.. ...... .. . ..... ........... .. . .... y 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 oug 0�( . skit VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARS Rough Service- ...................... ..... . ........ ......................... 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. SEE REVERSE SIDE DATE(MM/DDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 3/2/2012 THIS CERTIFICATE IS 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{les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). CONTACT PRODUCER NAME: M P ROBERTS INS AGCY INC O No Ext: 97$ 683-8073 C,No):(978)683-3147 1060 Osgood Street ADDRESS:miks@mprobertsinsurance.com North Andover, MA 01845 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: INSURED CENTER REALTY TRUST INSURER B: INSURER C: P.O. BOR 876 INSURER D: ZURICH NORTH ANDOVER, MA 01845 INSURER E: 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. INNS TYPE OF INSURANCE t a POLICY NUMBER (MWDD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $-DAMAGE TO RENTED _ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ ICLAIMS-MADE C�OCCUR MED EXP(Anyone person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMPIOP AGG $ POLICY jR, El LOC - $ AUTOMOBILE LIABILITY Ea accident $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED AUTOS AUTOS 8001LY INJURY(Per accident) $ NON-OWNED PROPERFrY GAARFAZE $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATIONATU- AND EMPLOYERS'LIABILITY TORY LIMITS ICTER ANY PROPRIETOR/PARTNER/EXECUTiVE Y❑ NIA WC005095106 02/10/12 02/10/13 E.L.EACH ACCIDENT $ 500,000 D (MandatOFF ory inNH)EMBER ExcLUDED9 E.L.DISEASE-EAEMPLOYEE $ 500,000 DESCRdescribe nder PTIONuOF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ rJ"00 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,T morespace is required) CERTIFICATE HOLDER CANCELLATION SAMPLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. Th ACORD25(2010105) e ACORD name and logo are registered marks of ACORD .%Z.. Nlassact�usetts- Mpartment of €'Lt3tic Sai'ets Board of Btlilding Rellulations asci Stanttards Coristruction Supervisor License License: C S 75302 ALUM BENJAMIN C OSGOOD 69 OLD VILLAGE LANE NO ANDOVER, MA 01845 Expiration: 12/4/2012 : 6267 ('.uun isviinrr