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Building Permit #181-11 - 33 SHERWOOD DRIVE 8/31/2010
BUILDING PERMIT NORTF/;°gtio TOWN OF NORTH ANDOVER �atb. _ op APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: q°q�r.°•P"'4y �SSAGH�1`-+�� r`� IMPORTANT: Applicant must complete all items on this page - - .� � �� _ �^£-^ —fry-� -� e^ a. � m " T "� LflCA`li 1(OTl ice? -�+� fwfl 1 --�r Y. a Illlt 2 9 ROPERTY fl1NNER � / 't Prt .a - ir nn VIAP 2 � "PARCEL o `ZONINGANST-RfCT ; Histor c,I istl pct � eS , nO - )1Aaclilne Strop Vipage eyes ono 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 �v4ze�6 4Septic " x il1lll Floodplain � xWetlands '° WatershedDistdct ry 6, DESCRIPTION OF WORK TO BE PRWORMED: 17 Identification Please Type or Print Clearly) OWNER: Name: �GLh �J-QV Phone: �! Address: S ��' cru oc�� a � s a CO.IVTRAT _ hone* _ �( . va - : o Adcr2S5 T x.' t �' ' ,k ( R •%"tria SuV. eros©r's°Co asti ticti©� L�ceriSe x 'Date,. w } n Horne Improveiraerxt.License -.�'3 Exf% Date ._ . 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: $ FEE: $_ Lot- Check No.: Receipt No.: �-- NOTE: Persons contracting with unregistered contractors do not have access to4thhuaranty�fundd gnatureof i4gent/Owne = Signature o coritract ac; f I 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 t _ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on ? a Signature COMMENTS cz _ J - QA 6j S I L,J i�r� 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: �-' LocatedJ_;384-6s ood Street FlRE'DEPARTME 4T Temp":Dumpster bn si#e fires, ono tocated��at12UA 4:NlamSreet Fare , tixien#signature/d epaate x ft " a jCOM_MEN TS � 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 for pickup - Date Doc.Building Permit Revised 2010 Building Department i + The following is a list of the required forms to be filled out for the appropriate permit to be obtained. I Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses o 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 3 Addition Or Decks Li Building Permit Application .,0K Certified Surveyed Plot Plan o ` Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses 131 'Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And H d ionsIf A le) ❑ Mass check ner port (If Applicable) V Engineering Affidavits for Engineered products NOTE: 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 i '+ ❑ 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 Revised 2008 Location�6'"i �G1. � ►" No. Date ' NGRT TOWN OF NORTH ANDOVER 3:''t�•e .•.• c ►°. - ,' 9 Certificate of Occupancy $ scMUst`A Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 1(� 23 � . : Building Inspector 22. 910 ✓ Of 60f Cle 2i f � r 0 0 L w0 t 0 (rota/ Lot) r 1.40 Acres N' \ ' Limit Of Dimensional fie uirements 4 48,275 7. 11 Acr Upland = 48� - (222 of ' O� FXlsting ` concrete �. Foundation B 1 ' Sep tic YTank A r / (1500 Gallons 1 ` I • 7 4 � Top of Foundvtion �/G Elevation 153.74: c P 93-210 E Lot 18 3 W V) W t J ' J w 95-2 6- vi t Jt K 95-3 t. t t g9 l Rj2 f ' 1 0 08/26/2010 09:20 FAX 6037726547 HOYT COSTELLO INS 121001 =(MM/DD1ffYYMYACORD CERTIFICATE OF LIABILITY INSURANCE PRODUCER (978)374-6352 FAX (978)521-5127 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY COSTELLO INSURANCE AGENCY I1ND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 2 South Kimball St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO Box 5248 NAIC# Bradford, MA 01835 INSURERS AFFORDING COVERAGE INSURED Eastern Shed Company, Inc INSURERA: Peerless Insurance 24198 39 Barthelmess Lane iNSURERB: Granite State Insurance Co Hampstead, NH 03841 INSURER C: INSURER D: 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 I'D ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MSYLTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM1DD/YYYY DATE MMIDD/YYYY LIMITS GENERAL LIABILITY CBP8573720 11/15/2009 11/15/2010 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ 50,000 CLAIMS MADE a OCCUR MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY $ 1,O00,000 A GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ji0 LOC AUTOMOBILE LIABILITY BA8570723 11/15/2G09 11/15/2010 GOM BINED SINGLE LIMIT $ (Ea accident) 1,000,000 ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) X SCHEDULED AUTOS A X HIRED AUTOS BODILY INJURY $ (Per accident) X NON-OWNED AUTOS G,'.. PeOa£ckchTYDAMAGE $ AUTO ONLY•EA ACCIDENT S GARAGE LIABILITY EA ACC $ ANY AUTO OTHER THAN AUTO ONLY: AGG $ EXCESS IUMBRELLA LIABILITY CU857342S 11/15/2009 11/15/2010 EACHOCCURRENCE S 2,000,000 AGGREGATE $ OCCUR CLAIMS MADE - $ 2,000,000 A �� $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION X TORY LIMITS ER AND EMPLOYERS'LIABILITY Y/N WC007426802 04/12/2010 04/12/2011 E.L.EACH ACCIDENT S 100,[!00 ANY B OFFICER MEMBER EXCLUDED ECUTNEa o E.L.DISEASE•EA EMPLOYEE $ 100100( (Mandatory In NH) If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below { OTHER 0 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECI,AL PROVISIONS it i j OLDER CERTIFICATE H CANCELLATION SHOULD ANY OF:THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION -_ DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR DIANA NGUYEN REPRE&ENTAT i! 33 NA NGUOCI.DRIVE 7!n,N1988- IVE NO TH ANDOVER, MS 01845 ACORD 25(2009101) Oc 009 ACORD CORPORATION. All rights reserved. he ACORD name and logo are registered!marks of ACORD j All joists are double 2" x pressure - a treated 1 ! pine. F- ! I C I All screws ;' are s i to nl ess �. st eel: --� i 10' sW68 All l (125 1/18- n ails are k v galvanized 1 ! AR - rX f: ! 7 -� (47.375° Deck Framing. For raj 9 Octo on Gazebo y �r .Inch - I foot 6ILK dam r Gtr j 1 P7— • e--Ll�- NQRT#q Andown ® '. . ®ver No. -o dower, Mass., 0 LAKE �. COCHICHEWICK V A�RATEO Pp <C' l S ` BOARD OF HEALTH ERM I D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.................1.....✓......1. '� ��4.......... ...................... .. .! 1.... ....................................................... Foundation 2\) has permission to erect........................................ buildings on . ....... . . !1.�.�1.. �7 ....:..... ....�' Rough to be occupied as .�T� � .f...... � .0.. 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 CONSTRU�CTIO T S 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 Smoke Det. EASTERN SHED DATE SHED#(:22aSIZE 49x Width x Length COMPANY MODEL: ❑QUAKER 0 CHATEAU ❑ASPEN 0 DELMAR 0 GAMBR ;GAZEBO (978) 688-4222 SIDING: OPINE O CEDAR O VINYL FAX: (978) 688-4244 WWW.EASTERNSHED.COM Shed Price $ Total cost of ee) CUSTOMER INFORMATION options from below $ �7 NAME Sub Total $ STREET p Sales Tax $ ap t_ Sub Total $ . CITY (► Moving Charge $ STATE ZIP HOME PHONE ( 92 Carrying Charge $ ) qz� g�Q Delivery Charge $ Sub Total $ REMARKS Deposit efis Total Amount Due Upon Delivery $ - OPTIONS QUANTITY ITEM COST FOR OFFICE USE ONLY Door Exchange $ Add Door $ Ramp $ c Add 1'wall height $ ROOF COLOR: SALES PERSON Pressure Treated Floor Plywood LAC tC� VINYL SHED INFO LY: OG Y Cupola Siding Color: . P 540 Shutter Color: PLACEMENT OF DOORS AND WINDOWS SIDE ) $ FRONT TOTAL COST OF OPTIONS $ (Length) FOR OFFICE USE ONLY: SPECIAL INSTRUCTIONS Date Delivered AMOUNT RECEIVED $ Check# d ZEN 11111111'', z �c v. 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Choose'Your�RoofI till Y � ❑ Cedar Shakes ❑ Rubber Slate r7 " Chestnut Brown Midnight Gray Red Green41 ° ❑ 3 Tab Asphalt Shingles W � > ^� Antique Black Burnt Bark Brown Chestnut Desert Shake Dove Gray Silver White Weathered Wood ` Y ❑ Architectural Dimensional Shingle .� Y Weathered Wood Rustic Evergreen Olde English Pewter Rustic Virginia Slate Rustic Cedar Oxford Grey Rustic Slate Rustic Redwood Rustic Black fx.. ❑ Metal Roof Clay Brite White Black Blue Brown Red Gold Tan Gray Charcoal White Stone Evergreen Burgundy 8. Choose Y urFloo a . ❑ Pressure Treated ❑ Redwood Decking ❑ Cape Cod Gray Decking ❑ Cedar Decking Ft4 } yr %d r R ✓cam .�.�}1/v Jt�+. - .. ;w + ' _ y9:PckYour `O tions; ` Wood vinvi f . f� ❑ Screens ❑ Decorative Spindle ❑ Screens To Rail A P ❑ Decorative top rail is standard on LJ Decorative Spoke y �W Yr •� � T"Rail �` � o_ u�l Gazebos