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Home My WebLink AboutBuilding Permit #314 - 28 MORRIS STREET 10/19/2006 TOWN OF NORTH ANDOVER NORT1� APPLICATION FOR PLAN EXAMINATION of'-ft-6o ,•�ti . o Permit NO: Date Received +�r� t Date Issued: 1ss�cHus�tg IMPORTANT: Applicant must complete all items on this page LOCATION 1-3 AJ A r)d(:-L>v-Cr Pr' PROPERTY OWNER ��s�/� / �d'17 Print MAP NO.:� PARCEL ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building VOne family El Addition ❑Two or more family ❑ Industrial 'Alteration No. of units: Repair, replacement ❑ Assessory Bldg G Commercial Demolition. . Moving(relocation) ❑Other ❑ Others: Foundation only DESCRIPTION OF WORK TO BE PREFORMED Identification Please Type or Print Clearly) OWNER: Name: s�CW111 IVC, /JprrC>�j p Phone• �7S l a y- -!�S30 Address: C"g �vccs S CONTRACTOR Name: T� _�-,j n.�, �,�V,� Phone: l7d�r` �7 Address: O� fox e4 a 7 Gam,-A,6 iyJ Supervisor's Construction License: 6 3St Exp. Date: 031cv`7 Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: ,Address: Reg. No. FEE SCHEDULE.BULDING PERM/T.•,S12.00 PER$1000.00 OF THE TOTAL ESTIMATE"OST BASED ON$125.00 PER S.F. Total Project Cost :$_� -O!� FEE:$ Check No.: 71 Receipt No.: 11nge I of 4 J TYPE OF SEWERAGE DISPOSAL TanningiMassage/Body Art ❑ Swimming Pools G Public Sewer Well �i Tobacco Sales 1] Food Packaging/Sales Permanent Dumpster on Site Private(septic tank,etc. _! Electric Meter location to project I NOTE: Persons contracting with unregistered vntractors do not have access to the guarantyfund Signature of Agent/Owner Signature of contractor Plans Submitted ❑ Plans Waived Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS FIRE DEPARTMENT - Temp Dumpster on site yes no Fire Department signature/date 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 it Building Setback ( Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. I: NOTES and DATA— For department use I, Page 3 oP4 1 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 j� CrcvedJniC Lm-'006 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 Addition Or Decks ❑ Building Permit Application ❑ 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) 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 o Mass check Energy Compliance Report 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:BPFORN105 I Page 4 of 4 I Location No. �� Date MaRTN TOWN OF NORTH ANDOVER O'i«•n •'�.S,O Certificate of Occupancy $ CH Building/Frame Permit Fee $ i ' s� us I = Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # � 19710 Building Inspector III Y ..q {s>I ued: EaTlfiEb .' " CHIMNE March 2006 .SWEEP. Allo '� W r. 3/07 ion 3 CSIA Certified Chimney Sweep 2155 Commercial Drive,Plainfield,IN I IIIIII VIII VIII VIII IIII IIII * 6 3 t -;y 7 i I ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MMIDDIYYYY) CHIMN-1 06/27/06 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Dan Hurley Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Chestnut Green, Suite 24 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Seven Federal Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Danvers MA 01923-3620 Phone: 978-777-9394 Fax:978-777-3306 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Essex Insurance Company INSURER B: Chimney Guys INSURER C: Scott Hunt{ Craig Masons PO Box 4074 INSURER D: Peabody MA 01960 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN5K ROD' POUCY EFFECTIVE POLICY EXPIRATION LTR INQ TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE(MWDDIM LIMITS GENERAL LIABILITY EACH OCCURRENCE $500000 A X COMMERCIALGENERALLIABILITY 3CU7238 06/23/06 06/23/07 PREMISES(Ea occurence $50000 CLAIMS MADE a OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $500000 GENERAL AGGREGATE $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS COMP/OP AGG $500000 X POLICY CT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS I I ER EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ H yea,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS As per policy. CERTIFICATE HOLDER CANCELLATION FORINFO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN For information purposes only. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Please contact agency for IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR individual certificate. REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Daniel J Hurls ACORD 25(2001108) ©ACORD CORPORATION 1988 � NORTIy own ot 4Andover No. ` % = LA E dover, Mass.,f 16 COC MICKEWICK I . 7,p ADRATE D Cl) `r BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT..... Q.. �!�i........ ..�.� rA.. ........................................................... Foundation has permission to erect........................................ buildings on ..&9 .�....N.-AA.K.N..1 ......I........................... Rough to be occupied as"a Qaf....&A.v4.......t...... .. .C . .. .. ....... ................................................... Chimney .. provided that the person accepting this permit shall in every respect c to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to a 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 30000 PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU ST TS 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 Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE J1 Smoke Det. 41bJZ � ® HoMESAVER, Date CHIMNEY RELINING SYSTEMS Dealer name Work Propos� Street i City, State, Zip Phone SUBMITTED TO: Name _ A�1_17ir 01174:7 0 E-mail Street Job Location City, State, Zip N. 4.7 , -ic,_ Phone JOB DESCRIPTION: S c3 C c,cS-1-csi✓J cl-4b//�,- ��- � 57�/�J/rs'�/ c�tt_// in f'u/ct�t./✓' CiilM/l J J-v S�./_[�/'a✓h C��n -� /'der '�X�[n.✓i� � Ft.G !0' T, e^,rt s'A /'�or� �2r s,1~ Gc.� �-,term 9� .�/G'S�. 410oX L. G✓t. Clfj /�^,,�r1 S1�o✓Y A!/J{ C �vC�D.n !/,,l,��ii�.C�/// � a//fP /.7 �> .d•na 7` �GT.�� C/7 al �..Yn�/J�G /D_11� G1-VL10 S TERMS OF PROPOSAL: Amount $ �rZSaUt Proposal good for 3 days. All material is guaranteed to be as specified. All work to be com- pleted in a substantial workmanlike manner according to specifi- Terms of payment 0 �/� 6 W,,P ��l1d►'� cations submitted, per standard practices.Any alteration or devia- tion from above specifications involving extra costs will be C !-� executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Property Authorized signature owner to carry fire, tornado and other necessary insurance. Our workers are fully covered by Workmen's Compensation Insurance. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature Date of acceptance Item#99286 ©2003,CCSI