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HomeMy WebLinkAboutBuilding Permit #045 - 240 SUTTON HILL ROAD 7/18/2008 BUILDING PERMIT oq "°oT" qti TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION00 yS Permit NO: Date Received '21,9 w°Awreo►�`�(9 SSACHU`�E Date Issued: IMPORTANT: Applicant must complete all items on this page cc f 1, j 111 LOCATION ;-719 r 1" ' ` 9=7) Print PROPERTY SINNER b W t u t Print MAP NO: 4;6 PARCEL:I ZONING DISTRICT: Historic District yes 'no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Resid Non- Residential New Building One famil Addition wo or more family Industrial Alt No. of units: Commercial Repair, replacement Assessory Bldg Others: emo i ion Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PREFORMED: ,T -g ( ,e -f- &ko 6 identification Please T e or Print Clearly) OWNER: Name: L Phone:? /F Address: a� �d Sv 0,J Ytiz L CONTRACTOR Name: Phone: Address: d GU d Supervisor's Construction License; / p1. �5 Exp. Date; Home Improvement License: Exp. Date: - ;Z610 ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. ©o Total Project Cost: $� SB o FEE: $ Check No.: Oy< Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Owner Signature of contractor Ii 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: 2- 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) i ❑ Notified for pickup - Date 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 o . 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 i No. © Date 7 rf HpRT1y TOWN OF NORTH ANDOVER O + Certificate of Occupancy $ �'�s'••° MU�tt�' Building/Frame Permit Fee $ � AC S Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 2 537 A , r Building Inspector NORTH c Town of : tAndover No. o yy dover, Mass., ;04 T COCHICHEWICK '_1. AORATEO PPa` �C `S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System � BUILDING INSPECTOR THIS CERTIFIES THAT...........�_. .'f: � ! `"� .................. ..............:..................................................................... .................... Foundation has permission to erect........................................ buildings ons' �'`_ .. ?� .�l ........................ Rough ... .............................. . ....... .. to be occupied as ���..� �...... ....6 � �! Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application 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 STARTS Rough .. ..................................................... Service BUILDING INSPECTOR Final Occupancy 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 Apprpved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. �' DATE(MWOONYYY) C RTIFICI�4TE OF LIABILITY NSURANCE 03/25/2008 PRouICVR (781)438-5000 FAX (781)438-5028 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION New England Heritage Insurance Agency Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 335 Main Street HOLDER,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Stcnnelnm, NA 02180 ALM THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL# INSURED A B Carnes Joc. WSURERk Essex Insurance Co. 30 Arrow1wad Farm Rd. aoswmv AIG AMERICAN WrERNL GROUP INC Boxford, MA 01921 wxwato INSURER& E: COVERAG ES INSURER THE POLICIES OF INSURANCE LISTED earn HAVE BEEN ISSi9m TO TIDE INSURED NAMED ABOVE FOR T#IE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,TERM OR COMNTION 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_AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSAM . TYPEOPINSURA"CE POLICY Z ILICYfFFEC#TVIc R'OLICtrfXP+IRATTON LIMITS GIFlQERAttBA�LNf TBD MAW= 03/18/2009 EAc;woccURRENcE $ 1,000,001 X COMMERCIAL GENERAL UOSILMY DAMAGE TO RENTED $ S0,001 CWMS MAGE OCCUR MED EXP OM ane Pte) $ S'001 A PERSONALE ADV INJURY S 1,000,001 GENCRAL AGGREGATE $ 2,000,001 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPKVP AGG $ — POLICY I ILOC AUTONIOSILE LIABILITY ANY AUTO COMBINED 131NGL£OMIT $ ALL OWNED AUTOS BODILY NilURY SCHEDULED AUTOS (P-P—) $ HIRED AUTOS BODILY NON-OWNWAUTOS (PeraeUdW)� $ PROPERTY DAMAGE (P-accident) $ i r AGE UABRM AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN £A ACC $ AUTO ONLY: AGG $ EKCESSKRABRELLA Lt400M EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ S DEDUCTIBLE $ RETENTION i $ WORKERS COMPENSATM AND WC 844.90-76 03/31/2008 03/3 T/2009 JMsTAjR, OTh- EMPLOYe S'LIAMLITY B ANY PROP IMT OwP E.L-EACH ACCIDENT $ 1,000,00C yes, � ? E.L.DISEASE-EA EJ�IPI Or s 1,000,00( SI�CIAL PROVLS M bel E L.DISEASE-POLICY LIMIT $ 1,000,00( OTHER DESCRIPTION OF OPERATIONS/LOCATION$I VEHICLES I EXCLUSIONS;ADDED BYA NPR ontractor Subject to terms, con i't oETns/SPE, enbrseFRALwITISnts and exclusions on the Policy. i CER71FICATE HOLDER- SHOULD ANY Or-THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXWRATION DATE TNEREOF.THE ISSUING,INSURER VNLL ENDEAVOR TO MAIL -1-0 DA`3 WRItM NOTICE TO THE CERTIVICATE"OLDER NAMED TO THE LEFT, BUT F=AILURETO AWL SUCH NOTICE SHALL IMPOSE ND 08UGATION OR UABILITY "PROOF OF INSURANCE COVERAGE ONLY" OFANYIWBIUPONTHEINSURER.ITSAGENTSORROnUMkTATNES. SPECIMEN COPY ONLY AUTf ROWRESINTATIVE WiT'Niatn Ntell ACORD 25(2001108) r�aarnl�n�nlaDnraeTlnul�nsln I Date....... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING ,SSACHUS This certifies that ....................................OEs 3��6 ......................................................... has permission to perform A9�WAe4-1- --h-(771-6-f-V ........................................... wiring in the building of..................... ................................... -7a"� at........C�.... ........ /........................./...................... ,North Andover,Mass. Tic.No. .-2-1.P.7.3.................... .... .. .. ......... Fee../0 S..-.ag ELECTRICAL INSPECTOR Check #s-ql5- 7973 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Date Issued: APPLICATION FOR PERMIT TO PERFORM, ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN NK OR TYPE ALL INFORMATION) Date: 1- .21- 09 City or Town of�/9/L/n C Vt;/Z To the Inspector of Wires: By this application the undersigned gives notice or ms ox her intention to perform the electrical work described below. Location(Street&Number) ?_Lf 0 S V T-10 cJ 141 LL (AA . Owner or Tenant M2 UJ R I T-C Telephone No. Owner's Address J-1 k6 Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate tB./ox) Purpose of Building Utility Authorization No. L_10 0 /& 1/0 Existing Service_16f�_ Amps /2z� /Z Volts Overhead ® Undgrd ❑ No.of Meters 4� New Service U 0 Amps 2- 12 VO Volts Overhead Undgrd ❑ No.of Meters Number of Feeders and Ampacity /WC ,5e—ot-V.(ec 71z� 1400 /1r'l/110 S Location and Nature of Proposed Electrical Work: /eo U 6/J - 0��—I/VI J,4 J 6JJ/ It/4-6 V0 /TCAA_-W_ gip® /I s`t -! 6-77 �( Completion of thefollowing table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA �No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- ® o.o mergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals: I I Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local El Municipal El Other �t Connection No.of Dryers Heating Appliances KW Security Systems: t No.of Devices or Equivalent No.of Water Kms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHEF Attach additional detail ifdesired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE W] BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 1—;2/'Q S' Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: O e!�- /hd C OSI&W e /CtG A-7Z 1,-/GO-3 LIC.NO.:A: 7 Licensee: C e o� t Signature LIC.NO.: E: (Ijapplicable,er er 'eze t"in the license number line.) rl Bus.Tel.No.- &/ , 21936 Address: ro (k Z cot gewo 1N& Zip: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Phone: Insurance on rile: Will Fax: Permit Fee: Receipt#: Date: n f c�.u�- rJ<c I -ay a� !'�--7 ��� �� ��- �7-���ti `�