HomeMy WebLinkAboutBuilding Permit #899-12 - 2001 SALEM STREET 6/14/2012BUILDING PERMIT
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: C� /Z
Date Received
O`NOE:oT a\
4 �•
gDcoc � FP 4
TYPE OF IMPROVEMENT
PROPOSED USE
Residential
Non- Residential
ew Building
, a'One family
❑ Addition
❑ Two or more family.
❑ Industrial
No.
Q Commercial
❑ Alteration
of units:
[IRepair, replacement
❑ Assessory Bldg
❑Others:
❑ Demolition
❑ Other
epttc ;;'`IUelfi `rt
7777
Floodp1am IWet{ands ;x
���IVatershed District ;
3 4 _- 64A •. z ^t It
i i _ t _ _ .Y 5
❑Water`/SeWor
n�croioT�n� nr~ wnRK TO RE PREFORMED:
OWNER: Name: �26�
Please Type or Print Clearly)
Address: 41, Gflcow)f Ref 404A& Pb1-
e: 603 78C- 8-G
ARCHITECT/ENGINEER )9(2T RnSE 0-034, CWlrA4g&b* hone: X03 ('22Gc1��
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: $ /000 FEE:
Check No.:�_ a,,& -// Receipt No.: a6-ya
NOTE: Persons contracting with twiYegistered contractors do not have access to the
ty fund
a
t
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 AP ROVED
PLANNING & DEVELOPMENT ❑
COMMENTS eal Per 40e-�
DATE REJECTED DATE APP OVED
CONSERVATION El El(o � ' z)
COMMENTS A� M �p
DATE REJECTED DATE APP OVED
HEALTH ❑z -
COMMENTS Id //
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
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
Nu i tb ana IJA i A — (vor department use
❑ 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
❑ 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)
o 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 2.2007
Locatio
No. Date(., -13. /I—
V I
TOWN OF NORTH ANDOVER
Certificate of Occupancy
rame e' e
=ing
Foundation Permit Fee
s/
er PermitFe
$
TOTAL
$-
Check #-i2g&
25413 Building Inspector
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FOUNDATION PLAN
Greenscape Property & Bldg.
O y
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THE PLYMOUTH
66 GILCREAST ROAD
LONDONDERRY, N.H. 03053
6�
p
N
FAIRFIELD SERIES
Tel:(603) 425-2300 FAX:(603)425-7861
ACOR&
lk.� EVIDENCE OF PROPERTY INSURANCE
F DATE (MM/DD/YYYY)
DEDUCTIBLE
1 4/24/2012
THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST.
AGENCYPHONE (603)669-3218
N Ext):
COMPANY
FIAI/Cross Ins -Manchester
Harleysville Ins Co
1100 Elm Street
355 Maple Avenue
Manchester NH 03101
Harleysville PA 19438-2297
FAX ,A1C.
IC No): (603)645-4331 ADDRESS, rkennedy@crossagency.com
CODE: 75-2631 SUB CODE:
AGENCY
CUSTOMER 00135873
INSURED
LOAN NUMBER
POLICY NUMBER
Earth 2 Sky Construction, LLC
�CIMOOO00034228E
Gilcreast Road
EFFECTIVE DATE
EXPIRATION DATE
F66
CONTINUED UNTIL
3/1/2012
3/1/2013
TERMINATED IF CHECKED
Londonderry NH 03053
THIS REPLACES PRIOR EVIDENCE DATED:
PKUPtK 1 Y INFUKMA I IUN
LOCATI ONID ESC RI PTION
2001 and 2005 Salem St., N. Andover MA
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
EVIDENCE OF PROPERTY INSURANCE 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.
COVFRAGF INFORMATInN
COVERAGE 1 PERILS I FORMS
AMOUNT OF INSURANCE
DEDUCTIBLE
Builder's Risk
$250,000
$5,000
mr-wimmma jinumuing a eclat uonumons
Amount of insurance limit is per location
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.
Town of North Andover
120 Main Street
North Andover, MA 01845
MORTGAGEE ADDITIONAL INSURED
LOSS PAYEE
LOAN #
AUTHORIZED REPRESENTATIVE
L Nolan, CPCU/JSC
AL,UKU Z (ZUUV11Z) U 1993-2009 ACORD CORPORATION. All rights reserved.
INS027 000q»im Tho ArnRn name and Innn arc ranictaraei mance of ArnRn
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CURRENT ZONING: RESIDENTIAL, R— 2
MIN. LOT AREA: 43,560 S.F.
MIN. LOT FRONTAGE: 150 FT.
SETBACKS:
FRONT. 30 FT
SIDE: 30 FT
REAR: 30 FT
�' STEPHEN E.
is
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tiAREA=220,496 S.F. /N1
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PROP. PCRC \
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PLAN OF LAND
PROPOSED HOUSE LOCATION
IN
NORTH ANDOVER, MASSACHUSETTS
DRAWN FOR
GEORGE HASELTINE
2001 SALEM STREET
NORTH ANDOVER, MA
SCALE: 1"=100' DATE: MAY 9, 2012
0 50 100 200 300
MERRIMACK ENGINEERING SERVICES
99 PARK STREET
5/7/12 AhWOVAR MASSACHt1SB7"1S 01810
DATE PHOAM (976) 475-9555 FAX: (879) 475-1448
1 11 EMAIL• AMMN"AOL COU