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Home My WebLink AboutBuilding Permit #287 - 35 MERRIMACK STREET 10/11/2006 TOWN OF NORTH ANDOVER t►ORTF/ APPLICATION FOR PLAN EXAMINATION ° 40"Lo '616 • Permit NO: Date Received I '��' W fA �' Oho<oc.wc crrtw`' Date Issued: ' Y �9SSACHUS�� IMPORTANT: Applicant must complete all items on this page LOCATION 2)E� 100�t"j e�I:k 54- �V D ,�,ri _ Print PROPERTY OWNER I/ Z 1J 1nn Print MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non-Residential C. New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: XRepair, replacement ❑ Assessory Bldg gCommercial ❑ Demolition ❑ Moving(relocation) ❑ Other �j 11Others: El Foundation only DESCRIPTI F W RK TO BE PREFORMED ii Identification Please Type or Print Clearly) OWNER: Name:�,1r1.Gttr �rP� �t'2-� Phone:979 ta-3 Address: S4-, CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECUENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERM/ $12.00 PER$1000.00 OF THE TOT4L ESTIMATW COST BASED ON$125.00 PER S.F. Total Project Cost :$ ( 02 s FEE:$ iCheck No.: �•��D�2. Receipt No.:_ Page IoP4 TYPE OF SEWERAGE DISPOSAL Swimming F1Tanning/Massage/Body Art ❑ g Pools 11Public Sewer Well Tobacco Sales Food Packaging/Sales ❑ ❑ Permanent Dumpster on Site Private(septic tank,etc. Electric Meter location to project NOTE: Persons contracts g " ith u egis er d c ntraetors 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 ❑ El- COMMENTS 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: Continents Conservation Decision: Comments Water& Sewer connection/Signature&Date Driveway Permit Date Driveway Permit Building Setback (ft.) 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. ft.: NOTES and DATA— For department use) Y Page 3 of'4 Doc:INSPECTIONAL SERVICES ES DEPARTMF.N"f:BPFORM05 Created 1MC—Ian.2000 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 o Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract ❑ 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 DEPARTM ENT:WORM 05 Page 4 ot'4 LocationQ5� Ow;bw (5j No. Date �ORTM TOWN OF NORTH ANDOVER A a Certificate of Occupancy $ CHU Building/Frame Permit Fee $ S45 Foundation Permit Fee $ Other Permit Fee $ Q TOTAL $ f� Check # 19679 Building Inspector t TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTINIENT 1600 Osgood Street Building 20, Suite 2-64 e 9S'SE��y North:Xndover, Massachusetts 01845 ^cwu`� Gerald A. Brown Inspector of Buildings Telephone(978)688-9545 Fax (9?8)h88-954? HOMEOWNER LICENSE EXEMPTION Please Print DATE: lob JOB LOCATION:_ ��)� ;Number Street Address � y 1VIap/Lot HOMEOWNER �� 4? Name Home Phone Com " ��`�3�� Work Phone PRESENT MAILING ADDRESSNet LmA Fj City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned"homeowner"certifie th t he;she understands the Town of Nor minimum inspection procedures and r qui e lents and that he/she wi requirements. mp(y h spud procedoverdures and Department HOMEOWNERS SIGNATURE APPROVAL OF RUILDfNG OFFICL Rcvised 1o._1oo5 --- — 1 nm Humu,wncrs�xcmp(iun iOARD0F;1FPEi\L;ihrq_,)c,jI c PROPOSAUINVOICE _�_ East Coast Handyman J08 NAMEJNOPage of. 91 Broadway, Methuen, MA 978-397-6431 LOCATION To: 3 rYl Y-% YVA _ �! 0 0 PHONE DATE We hereby submit spedfications and estimates for: 0 O 4yi�(A v - 4Z`14 92 r a, ;# i ,r Imo;.•✓� -- WE PROPOSE her to furnish material nd labor-complete in accordance wits these specifications,for the sum of c9J D , —�-1 x car 2��1-1 Jnr.._ Dollars ($ Payable as follows: �f t, �� AS material is guaranteed to be as specified. All work to be completed in a Authorized -00�abo Eke manner according to standard practices.Any afteratioo or deviation from Signature spedf=b0ns irnntving extra casts will becorne an extra charge over and above T',!estimate. Aft agreements contingent upon strikes,accidents or delays beyond our NOTE: this proposal may be withdrawn by us a::14o1.Owner to carry fire,tornado and other necessary insurance. if not accepted within days. ACCEPTANCE OF PROPOSAL The 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 ✓� > �--- _ pie �� ) U6 Signature Date NORTH Town of �rAndover ��_ A K E dower, Mass..�/+��0 S D tt COCMIC.6"'CK y1. s ADRATED PPS` �y `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......�. .... ...............4660-0.%.........................................'............................ Foundation ar has permission to erect........................................ buildings on .35.... u .&...;.... ............. Rough • Chimney to be occupied as................ i . . .........t........... fa ft.• ............M4.�.....ttivwl.. y rovided that the erson acceptingtermit shall in eve res conform to the terms of the applicationile in P P P rll P F►nal 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 UNLESS CONSTRU O STARTS ELECTRICAL INSPECTOR Rough . Service BUILD SPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. _ — cut The Commonwealth of Massachusetts f n. Department of Fire Services Office of the State Fire Marshal V P.0.Box 1025 State Road,Stow,MA 01775 PERMIT Date: North Andover permit No (city of Town) (If Applicable) Dig Safe Num er In accordance with the provisions of M.G.L.14 8 Chap.ter_JD_as provided in section —522—LM R 34 Start Date gr This Permit is anted to: Full name of person,Firm or Corporation Permissionto locate dumpster for construction/renovation/demolition of building Comments: dumpster must be . 25 ' from structure if unable to place with required Restrictions: clearance dumpster must be covered with plywo. od or tarp end of work day at (Give location by street and no.,or describe in such manner as to provied adequate identification of location) FeePaidS 50.00 � � 1/� � Fire Chief This Permit will expire �' (Signature of offical granting permit) Offical granting permit (Title) ACQRD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) PRODUCER 10/06/2006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Harrington Insurance Agency, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 300 BROADWAY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR METHUEN -MA 01844 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED EAST COAST HANDYMAN- ALFRED VERDONE DBA INSURER A: NORFOLK&DEDHAM MUTUAL FIRE INS 23965 91 BROADWAY INSURER B: METHUEN, MA 01844 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 TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN RE SUCH REDUCED BY PAID CLAIMS. INSR ADD'L LTR POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER / LIMITS A GENERAL LIABILITY R0626644A 09/18/2006 09/18/2007 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES(Ea occurence) $ 50,000 CLAIMS MADE )( OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG ! $ 2,000,000 POLICY PRO 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 OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR FICLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS'LIABILITY TORY LIMITS: ER . ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ' If yes,describe under E.L.DISEASE-EA EMPLOYEE $ SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAY JOHN GREEN s WRITTEN 35 MERRIMACK ST NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL NORTH ANDOVER -MA 01845 IMPOSE NO OBLIGATION OR LIABILIWOANY D UPON THE NSURER, ITS AGENTS OR REPRESENTATIVES.AUTHORIZED REPRESENTATIVEtV / / ACORD 25(2001108) ©ACORD CORPORATION 1988