Loading...
HomeMy WebLinkAboutBuilding Permit #701-2017 - 32 JOHNSON STREET 1/9/2017BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit No#: -701 - P-701 Date Received l9 n!:,tp lcz-zi iriri- TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential 0 New Building 0 0 family ;rwo [I Industrial [J AVition or more family AIteration No. of units: 0 Commercial El Repair, replacement El Assessory Bldg 0 Others: emolition 0 Other ep ell" El tip ;� �f .1air! El Wet affi- 8 0 P Floodplain vv-'�ti gfi6d, Nk pid-i- 91 a Aii it DESCRIPTION OF WORK 0 BE PERFOKMLI): le, 6m ifelzonew4ft /, 411.4c e, 4A dpn Sat:-epwP54poz - 414oz-, d.,q"e sfwr6 Identification; Please Type or Print Clearly' OWNER: Name: L�c� Address: 7 &4 Ll--, S{- 95b-t0f, Name's ,p Phone:, Address _S.Upervisbr-s0bh§trub ionlieense Exp: - ---------- Date 6 M e, MY b&_dmb n t: License'.:.. i96 h s e,. 1A6 9; H fi-7 -_- ARCHITECT/ENGINEER Address: Phone: Reg. iso._ FEE o. z. FEE SCHEDULE. BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. ,,--,rotal Project Cost: $ aV FEE: $ o Check No.: Receipt No.: 4/ ? ng wi o nq wve. ess NOTE- PersoRs conte registered contra,4or� d t h e guarantyfund r _��,�trrh d16p- r4 / n -� h X(I SIC! Uro'bf coh­1r�ibV'fF.' ii�' nf.-A Plans Submitted 11 Plans Waived 11 Certified Plot Plan El Stamped Plans El TYPE OF SEWERAGE DISPOSAL Reviewed on 't Public Sewer El Tanning/Massage/Body,,Vt ❑ Sw"'Ining Pools 0 Well El Tobacco Sales El Food Packaging/Sales 0 Private (septic tank, etc. El PennanentDumpster on Site ❑ THE Odx L LO'Wil N"66 1'ECTIONS"FOR OFFIC E USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING & DEVELOPMENT COMMENTS Reviewed On Signature_ CONSERVATION Reviewed on Signature .A.,,COMMENTS -Li HEA TH - Reviewed on 't Signature COMMENTS Zoning ffibardnf.A.pp(iMs: Variance, Petition No: Zoning Decision/receipt submitted yes Planning 13bard D66sfo"n: Conservation Decision - Comments Comments Water & Sewer Con nection/signature & Date Driveway Permit DPW Town Engineer: Signature: FIRE DEPARTMENT' - Temp Dumpstor on site Located at 124,Main Street Fire Department.signatureldate COMMENTS yes d Street no -)imension Number of Stories: Total square feet of floor area, based 6h 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 Doc.Building Pen -nit Revised 2014 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 a 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 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 act ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products DOTE: 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 l v' Doc: Building Permit Revised 2014 Location N 4- 3 V JOE/NS"', E7 No. —701 - '9-0(7 Date Check # 9 a 9/(0 : 'I* Z, i7 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 300 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ `Building Inspector Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 25,000.00 m $ - $ 300.00 Plumbing Fee $ 37.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 37.50 Total fees collected $ 475.00 32 and 34 Johnson Street 701-2017 on 1/9/2017 interior renovations Enter construction cost for fee cal - North Andover Fee Calculation Construction Cost $ 25,000.00 m $ - $ 300.00 Plumbing Fee $ 37.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 37.50 Total fees collected $ 475.00 32-34 Johnson Street 701-2017 on 1/9/17 interior remodel 'V r L x J W x o O m L O u0.. v N O. N m O d z z m t6 3 LL 7� OC d U N LL m V d z ? co a bOD OC t0 LL m O V N zLL U w v W w O N U i N m LL z O a Z j d' _ (0 LL z W C C o~c o o: 6 L d i m N v N N y O N n -��0 W CL J 2 C Z 0 = o o� N V rE CL CD 4' r � _ i d O C T Jv 0 it0 = ■ o�Q Z ~ 10U)b.Z 10. ,,F * �: Q JE CC Mn t/) �! c d�� m W (n} �o 0 j a i/i (D�O w O oo �� N3 c W J t>0 Q.Z «•CLm 40NI __ L O =o c •O 1 O fn v m 4> aN w = -a-oo UJLL .(n fn = O .Q O N c +• Z W • C-) 4) O -0 4) Cl) CL N m O14- O F- rL 0 0 > .-. Ln ti A` oRa CERTIFICATE OF LIABILITY INSURANCEDATE(MM/D- F i�)17 __ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. -----------AODLISUBR THIS CERTIFICATE 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). PRODUCER CONTANAME: Sandi Munroe M.P. Roberts Insurance Agency PHONE (978) 683-8073 AX No: (978) 683-3147 1060 Osgood Street North Andover, MA 01845 ADDRESS: sandi@mprobertsinsurance.com INSURERS) AFFORDING COVERAGE NAIC # INSURER A: Travelers Insurance Co INSURED INSURER B CENTER REALTY TRUST EACH OCCURRENCE $ INSURER C: P.O. BOX 876 NORTH .ANDOVER, MA 01845 INSURER D: DAMAGE TO RENTED EBEMISES (Ea occurrence) $ INSURER E: I NSU R ER F: vvrG1[/1vCJ VCR I It IIIA I t IVUMM7111 DF\/ICIPMI k111tuloco 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. -----------AODLISUBR IN§R LTR TYPE OF INSURANCE I --- POLICY NUMBER - POLICY EFF M/DD/Y POLICY EXP MM/DDIYYYY ------------------------- -----"-_-. -- LIMITS GENERALLIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED EBEMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL& ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATELIMITAPPLIESPERDUCTS PRO - COMP/OPAGG $ POLICY PROT LOC $ AUTOMOBILE LIABILITY COMBciderrtINED SINGLE LIMIT Ea ac $ BODILY INJURY (Per person) $ ANYAUTO AULOWNED SCHEDULED BODILY INJURY Per accident $ ( ) AUTOS AUTOS NON -OWNED HIRED AUTOS _ AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A WORKERS COMPENSATION UB3F367937 2/10/17 2/10/18 DTH- X IIOR AND EMPLOYERS'LIABILITY y / N _.WCSTATU- E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOWPARTNER/EXECUTNE OFFICE RIMEMBER EXCLUDED? y N / A E.L. DISEASE -EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ 500,000 DESCRIPTIONOFOPERATIONSbelow DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is regli red) !`C0T1C1f1AT0 L1A1 Ml- -- - - ---- LIANktLL.AIIUN TOWN OF NORTH ANDOVER NORTH ANDOVER, MA 01845 ACORD 25 (2010/05) Phone: Fax: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED SENTATIVE r �14 ©1988-2010 ACORD CO The AC ORD name and logo are registered marks of ACORD E -Mail: TION. All rights reserved. —_ Office of Consumer Affairs & Business Regulation HOME IMPROVEMENT CONTRACTOR Type. Corporation Registration Expiration _ 186186 10/07/2018 Key -Lime, Inc . benjamin Osgood 10 Hepatica Drive t G_ North Andover, MA 01845 Undersecretary Registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, MA 02116 Not valiq without Ognature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS -075302 Construction Supervisor BENJAMIN C OSGOOD 69 OLD VILLAGE LANE NORTH ANDOVER MA 01845 f Commissioner Expiration: . commissioner 12/0412018