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Home My WebLink AboutBuilding Permit #344 - 201 SUTTON STREET 11/17/2008 BUILDING PERMIT o` "°oT" qti 6 TOWN OF NORTH ANDOVER �� ° '`- . . 0° APPLICATION FOR PLAN EXAMINATION 7D Permit NO: G Date ReceivedAr ��SSACHV Date Issued: fes. ' IMPORTANT:Applicant must complete all items on this page LOCATION Print PROPERTY OWNER Print MAP NO: �Z<� PARCEL:R(/' ZONING DISTRICT: Historic Distdct yes 3) Jachine Shop Village yes Q 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 Septic Well Floodplain Wetlands Watershed District Water/Sewer Q DES,CR/IPTION OF WORK TO BE PREFORMED: I J2 `e- xi -7-- S' P�/ , C P�IS Identification Please Type or Print Clearly) OWNER: Name: Cjf Phone: L�Y-2623'9,>C Address: CONTRACTOR Name: �c .� , J' ._- Phone' �Y .�sf ; Address:— fx . / ,,. /t�_00--1 Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date- ARCH ITECT/ENGI NEER ate:ARCHITECT/ENGINEER Phone: Address: 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: $ Z a v FEE: Check No.: Receipt No:: Z� NOTE: Persons contracting with unregistered contractors do not have.access to the guaranty fund ignature of Agent/Owner ignature ofcontractor 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 o- 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 signatureldate 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 foricku - Date P p Doc.Building Permit Revised 2008 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) { ❑ 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:Building Permit Application Revised 2.2008 Location No. ,��/ Date NORTIy TOWN OF NORTH ANDOVER • O 9 • s • � , , Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ * .— TOTAL $ Check # Z 7-Z 7 2 ; 6J �60ding inspector DATE(MMIODfffM ACORk CERTIFICATE OF LIABILITY INSURANCE 07f1712008 THIS CERTIFICATE iS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Coffin Insurance Agency,Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 359 Male Street INSURERS AFFORDING COVERAGE _ NAIC 0 Haverhill MA 01830 INSURER 0. Ern�o ars Mutual Casual CDm�aRy_,__ INSURED M,Silver Company Inc. IN TIER B; Insllrence I:OmpMYOf PennS�IlYdnla•__, 5 Market Square Suite 205 INsuitERC Ame2bury MA 01913 INSURER D: ...�__ INSURE E' COVERAGES :0 %FLOW HAVE BEEN THE POLICY THSTAWNU THE POLICIES OF; NS ERM USTE OF AN CONTRACT OR OTHFRD TO THE NDOCUMENT�WITH RESPECT TO WM CH THISI CERTFIICATEDMAY EI ISSUED OR ANY REQUIREMENT. MAY PERTAIN. TME INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EKGLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY NAVE BEEN REDUCED 6YPAID CLAIMS, LICY UFECINP POLI cr E RAnoN uwlTs INSR OV POLICY NUMBER EACH OCCURRENCE 31,0001000 � GENERAL LIABILITY0610111111 TO RENTED S OO,000 _. Osro11D9 P.REMISES.fF&Jz;reno� A X COMMERCIAL GENERAL LIABILITY 8D9Z716 M D Ext(Any one 9r56n CLAIMS MADE LO OCCUR PERSONAL 6 ADV INJURY, S--100,000 GENERALAOGREGATE_, !2,OOD,000 PRODUCTS-COMPIOP AGG R ,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- LOC COMBINED SINGLE LIMIT s AUTOMOBILE UABILITY 06!01108 06101109 tEa accaeN) __ A I ANY AUTO 9291718 —— oDDlly INJURY S1,000,000 ALL OWNED AUTOSll` (Par pateon) X SCHECVLED AUTOS 8001LY INJURY `1,00,000 X H1RE0 AUTOS per arc,.danu _ .— X NON1"FOAUTOS PROPERTY DAMAGE 1,000,000 (Per accident) AUTO ONLY-CA A_CCIOENT S GARAGE LW81ITY EA ACC OTHER THAN ANY AUTO AUTO ONLY; AGG S EACH 2EURRENDE. S 2 O00 GOD q(CESSIUMBRFILA LIABILITY 06101108 08101109 AGGREGATE _ 3 Z O,_OOIOOD A X OCCUR n CLAW MADE 9JO2716 a , DEDUCTIBLE Z X RETENTION 8 10�0 — X WC STATV- OTH- T.OR}_LIMI�. WORKERS COMPENSATION AND 1012812007 1OM812008 E.L.En!H ArQQE—N'r_ s 1,004000 fi EMPLOYER$LIABILITY WC6594"1 E.L.DISEASE-EA EMPLDYEE 1000_r-__J 000 ANY PROPRIETORIPARTNERIExECUT1VE 1, _—• OFFICERIMEMBER E%CLUDEO? NO F„L.DISEASE-POLICY LIMIT f 00O ODO If PEC FPR ube un NS b OTHER DESCRIPTION OF OPERATION91 LOCATIONS I VEHICLES 1 E%CLUSION9 ADDED BY ENDORSEMENT I SPECIAL PROVISIONS 978 688 9502 Commercial contractor. Certificate holler and In othf artfes asrequired by Con��are CELsted aN sditlDnal Insured on the eneral liability . li CERTIFICATE HOLDER SNOULDAN'r OF THE AOo�DESCRIBED POLICIES 196 CANCELLED BEF GRE THE pCf'IRA Town of North Andover DATE THI;RFDF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN Building North Ando NOTICE Tp THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 90 SHALL 1600 Building DOd It IMPOSE MO OBLIGATION OR L ANY KIND UPON THE INSURER,ITS AGENTS OR North Andover,MA 01845 REPRE9BNTATIVE9. AUTHORISr'D REPREEEN TIVE ®ACORD CORPORATION 1988 ACORD 25(1001108) V40 R TTly c ® of Ot.,err. ^'4 r.F,•. � � t V" No. 3 4/$/ T �O _ LAKE o dower, Mass., l/Z-/ I� COCMICHEWICK 7,9 A04ATEO `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System g / BUILDING INSPECTOR THIS CERTIFIES THAT...............D-�.�..`. .... �' �' l � �' �f..... ...... .. .i~...... ... . ..1 �'.v .................................... �` � Foundation - �� has permission to erect........................................ buildingson .... ....................................`.`�.......................................... Rough // Chimney to be occupied as...............1`... ..... >.......�'��.� t ?.c�. �,�'_ ./.......Coll y provided that the person accepting this permit shall iii every respect conform to the terma applic tion 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 ....... ........-'L" 1� .......... .............................. Service BUILDING INSPECTOR Final ®cctpawy 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. i gard of Builoiog Regulations andStandards Construction�Supervis,or License License: CS 3854 Biltbdate B1,23/i958 sEpi �tgn 8%2`3f2009 Tr# 942 Restriction MICHAEL D SILVER 5.MARKET SO#20"' AMESBURY,MA 01913'-.' Commissioner