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Home My WebLink AboutBuilding Permit #081-2017 - 22 HARWOOD STREET 7/26/2016 L BUILDING PERMIT o� NORTH q ,.[LEO /6 N 2 :�h Y6 Q TOWN OF NORTH ANDOVER o APPLICATION FOR PLAN EXAMINATION 4C � Z y Permit No#: G�s9 Date Received Ss R�TEp e Date Issued: IMPORTANT:Applicant must comp�lete,all items on this page LOCATION. HAi2hYdD0 � 1 (v��'� Print PROPERTY OWNER 6W#—&4Ct AvoiA Print 100 Year Structure yes •1 MAP PARCEL:_ZONING DISTRICT: Historic District yes Machine Shop Village yes 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 D-Septic o Well- b Floodplain ' o Wetlands _ ❑ Watershed District u Water%Sewer DESCRIPTION OF WORK TO BE PERFORMED: ►yo r7bs►t NG D€'ck N S ALL 10 Sd"A i V6-EJ DiasP Rt,5 u lub /J JEj./ ,?,x 10 t' I Dc(ls a ON is Identification- Please Type or Print Clearly o OWNER: Name: LAwRBNc9 �Av okA Phone: J �4 3 wf Address: A^ t��3� 9 I_ IualztN n,al"Ek Contractor Name: ( ECp (qxkz) Phone: 60 2,030 Email TF-0 6 N€xUScARff�� QQtA Address: 1; QLEwDALE De-Iyi�F Supervisor's Construction License: CS — 0-7-3 n1 Exp. Date: (+ `9 — g p Home Improvement License: 2� r� -7 Exp. Date: " ARCHITECT/ENGINEER Phone: ` Address: Reg. No. FEE SCHEDULE.BULDING PERMIT:$12.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON X925.00 PER S.F. Total Project Cost: $ �W" FEE: $ Check No.: Receipt No.: 2 O�w NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund -- -,— i _ Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer Tanaing/Massage/Body Art ❑ Swimming pools ❑ Well XCI Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORINT PLANNING & DEVELOPMENT1 � Reviewed On 7�z�1� Signature_ COMMENTS {� 64166, CONSERVATION Reviewed on Si nature COMMENTS )U4 �1 \ HEALTH Reviewed ori Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes j <a lanning Board Decision: Comments r' r Conservation Decision: Comments Vater & Sewer Connection/Signature & Bate Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPATMENT - Terhp Dum seer onsite yes. . . yis no Located at 124 Main Street Fire Department signature/date COMMENTS i f 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.$10041000 fine NOTES and DATA— (For department apse) ® Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 I 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 OTE: 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/Cross Section/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 OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit I 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 2012 I ECC Energy code Engineering Affidavits for Engineered products OTE: 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 I Location � 57 No. J "� Date ZZ/0 zo/G . - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ , Other Permit Fee $ TOTAL $ t Check#10 :� Building Inspector j� Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOS Public Sewer Tanning/Massage/Body Art ❑ Swi�"n"'g Pools Elwell ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ El ! Permanent Dunipster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF m U FORINT PLANNING M DEVELOPMENT Reviewed On ?�z� I�� Signature_ COMMENTS � 4 A 11G CONSERVATION Reviewed on � Si nature � COMMENTS MU HEALTH Reviewed ori Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes F r Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature� Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPAR-TMEONT - Temp Dumpster onsite yes. tits no Located at 12.4 Main Street - Fire Department signatureldate COMMENTS NORTI� Town of ndover No. h ver, Mass, Z 6 ZO/Ej C% LAK. �. COC KIc"a WICK V �as q�TED /.Pp��S U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT 44.41.0%C .......... BUILDING INSPECTOR . Foundation has permission to erect.......................... buildings on ....oz.. ......�j�.�..sLwo.....�. Rough to be occupied as .. .... ......PST, ar,. ......OF, ..... � ...... 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 CONSTR TION S Rough ervice ............ . ..... ... Final BUILDING IN CTO 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. oz�-own oTM....I over No. i ver, Ma Lk Je �� I O LA E ' SQA toc ni awl ` 1' �� OR 'no Jk S BOARD OF HEALTH Food/Kitchen PER T Septic System • THIS CERTI S THAT ........ ..................................... BUILDING INSPECTOR .............. ....... ....... ...e.... . ....... ...... ........... Foundation has pe ission to rect .................. ....... buildings on ..�. . ... ....... ........... . .................... - Rough to b occupied as ..t1!'t, p .............. ..... ..................... 4.�.... . ... Chimney p . . ............ ... ........... pro ided that the pe on accepting this permit s I in every re pest conform to the terms of the a licat n Final on file in this office, nd to the pro isions of the odes and By-L inns relating to the I pection,Alter ion a d Con truction of Buil ings in the T` n of North Andover. i e d 6J# 'ia PLUMBING INSPECTOR VIOL TION of the Zo ing or Buildin a ula ons Voids this P rmit. Rough 1 Final PERMI PIRES N 6 MONTHS ELECTRICAL INSPECTOR UNLESS CO TIO T R Rough rvice • ..W N WA 0 F..... ... .......... Fin BUI G I ECTOR GAS INSPECTOR ccupancy Permit Required to Occupy Buildinz Rough Display in a onspicuous 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. n v No C"!,Vla .� C�! � iv xlt C, ► r1oL's `,�Gc� 10 6F- EX f5! + G r D:)u6LC. ax, �A.-A) 9VUeC, Ifs _ t f Joi S i ;Joist ' l(�sl i4MCCus FlCor\ HOLJS C, DtOCICf��. SE Au- z,:,vocstop, rp-AmojG , o JA I �.a� s idrres North Andover MIMAP July 26, 2016 NY � . x. X , v r .. z 'f ,r a a1 t' u x • y r � n,a/`e, •' �' III I �I ��II • K- w , i r 1 C MVPC Bo Interstates I Horizontal Datum:MA Stateplane Coordinate System,Datum NAD83, —SR Meters Data Sources:The data for this map was produced by Merrimack NORTIy Valley Planning Commission(MVPC)using data provided by the Town of Roads Of 'Ca °q North Andover.Additional data provided by the Executive Office of t r Easements ? `a" •• GO Environmental Affairs/MassGIS.The information depicted on this map is Lj Parcels .. L 3 for planning purposes only.It may not be adequate for legal boundary +–• '"• odefinition or regulatory interpretation.THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES,EXPRESSED OR IMPLIED,CONCERNING �t >f THE ACCURACY,COMPLETENESS,RELIABILITY,OR SUITABILITY IL i ,^, x OF THESE DATA.THE TOWN OF NORTH ANDOVER DOES NOT +► 04 ��• # ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF THIS INFORMATION S$ACNUSE 1"=32ft .�r VSC'ERTIFICATE 016 08:34 FAX 978 532 2217 CROSS INSURANCE 2001 DATE(MM/DD/YYY1) CERTIFICATE OF LIABILITY INSURANCE 7/26/2016 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(ies) must be endorsed. If SUBROGATION IS 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)_ RODUCER CONTACT Lauren Goldman NAME :roes Insurance-Peabody IAl_CNa«Ext (978)532-5445 n� No_(979)592-2217 39 Lynnfield Street AODPXSS:lgoldman@croesagency.com INSURERJS)AFFORDING COVERAGE NAIC# beabody MA 01960 INSURER A Western World Ins. Co. ISURED INSURERB:Safe Indemnity 33618 lexuB II Services LLC INSURERC: 1.0. Box 2823 INSURERD: INSURER E: roburn NA 01998 INSURERI-: Y� :OVERAGES CERTIFICATE NUMBER:cL15102253381 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. ADDLISUSR �R TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑R OCCUR $ MPP8290737 6/12/2015 9/12/2016 MED EXP(Any ono porson) $ 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 X POLICY❑JECPRO- T E LOC PRODUCTS-COMPlOPAGG $ 1,000,000 OTHER Damage to Rented S 50,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea a¢ident ANY AUTO BODILY INJURY(Por Parson) $ 500,000 B ALL OWNED SCHEDULED AUTOS X AUTOS 3116632 11/10/2015 11/30/2016 BODILY INJURY(Per eccldenq $ 500,000 NON-OWNED PROPERTY DAMAGE R HIRED AUTOS �` AUTOS Per a Iqe� S 100,000 Medical 0symenLe S 5,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION S $ WORKERS COMPENSATION IFER H- AND EMPLOYERS'LIABILITY YIN STATUTE I ER ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFPCER/MEMDER EXCLUDED/ NIA (Mandatory In NH) E.L,DISEASE-EA EMPLOY $ 11 ea,tleaaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S ESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101,Additional Remarks Schedule,may be attached If more space Is required) te: Yonchak Project :ERTIFICATE HOLDER CANCELLATION 978)688-9542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of North Andover THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: Don Belanger ACCORDANCE WITH THE POLICY PROVISIONS. 1600 Osgood St North Andover, MA 01845 AUTHORIZED REPRESENTATIVE Lauren Goldman/MD1 of4a42A ®1988-2014 ACORD CORPORATION. All rights reserved. (CORD 25(2014/01) The ACORD name and logo are registered marks of ACORD MS025(201401) f it G.F fr�k�5�t EMS ` - vip y ff{ 10 f e �t j �c r r + i i TWA>s A UM13AG4 LOAN%SPECT i FOR fHUMt Ul PV^PDSE,S OMLY .. - .. ! -" r�wr�ra!y ryr(k►9t ! [11R..;F3,� it r�yZe i�x*{irxa4. �N;w w...z�,��n;.*«.�,tea.•� Pis wet tM oppc«z w'ns'q&#,4"tv+wtw %t arca"home"r*- ; rrrnw ar or t?+s w*&b!x~COO Gk-Kstoft 4 RMroY std ma tho M*uctWaF !den on qna ptsn Is 11CT • . a0ow.ia1w•SpKW FMO HUMO Ans u Oskn"ts0 on SN FAM mV of TtM ow""prWoved in owft n tD vo rigrlwjw"Of NM cwrtm++match or MlftliiCt�ANrtli m CUA aB3. 8 ) F6