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Home My WebLink AboutBuilding Permit #83 - 400 OSGOOD STREET 7/28/2009L - Permit NO: 1�3 Date Issued: ? 2k -p TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received I IMPORTANT: ADDlicant must comDlete all items on this -oaae I LOCATION Wo 05�260 1 Print PROPERTY OWNER Z>4 Print MAP NO: '74f PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial ��, �cement Assessory Bldg Others: 'bemolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer DESCRIPTION OF WORK TO BE PERFORMED: JL s,)57^.e e. I-, %po. c e I fi . I d9pti ication Please ;r�Le or Pnint Clearly) -- OWNER: Name: Phone: '7 7&( �W,7 Address: '-ry ea VE r z3F CONTRACTOR Name: �5c f!2z Phone: Tair Address: wo 5-/ :25viyrre, /Im Supervisor's Construction License: 3LI _Exp. Date: Home Improvement License: Exp. Date: ARCH ITECT/ENG IN EER '77j' J -3A 0314 Jen J-C,,N Phone: V Address: je,�A / �-f I 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: $ - — cl�, 0 FEE: $ DLO 13S40 Check No.: Receipt No.: Z2,Z&K NOTE: Person's conlracting with unriegistered contractors do not have access to the gliarantyfun,J ignature of Agent/Owner Signature of contract (1�tamped Plans Plans Submitted Plans Waived Certified Plot Plan 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 DATEAPPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH- Reviewed on Signatu-re COMMENTS Zonin . g Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conser�ation Decision: Comments Water & Sewer Con nection/signature & Date. Drivewav Permit.. DPW Town Engineer: Signature: Located 384 Osgood Street FIR ' E DEPARTMENT - Temp Dumpster on site yes no 'ted at 124 Main Street Loca Fili Department signature/date COMMENTS 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 21 A —F and G min.$100-$1 000 fine NOTES and DATA — (For department use) LJ 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 Ei 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 u Building Permit Application Li 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) Li 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) L3 Building Permit Application Li, Certified Proposed Plot Plan Li Photo of H.I.C. And C.S.L. Licenses Ei Workers Comp Affidavit Li Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Lj Copy of Contract L3 Mass check Energy Compliance Report Li 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 peal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording "fed with the building application Fr Loca e Fir D' )- I c.Building Pennit Revised 2008 Location /00 No. Date 7-0?01-0� 22 - Building Inspector TOWN OF NORTH ANDOVER 0 Certificate Occupancy of $ CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check# 22 - Building Inspector JUL-28-2009(TUE) 07:45 C P BERRY P. , a u l/u I u I —AW"N", DATE (MMMD" 01 23/69 tkl%v-.q 'N 0 NFORMATION Ir - .. R 1I.CEIMIFICATErIWASSUED AS A MATrER' PROIDUCER. ONLY AND* CONj:ERSt;,NO.RjGKm UPON 'THE CEFrnRCATE A STEVENS, C . 0 � INC HOLDER. THIIS'cIERnF *rk, 'NOT.'AMEND, EMNO'OR 11:W � DOES ALTER THE C6VERAGE:AfFORDED By, POLICIES BELOW. -.COMPANIES w AFFORDING COVERAGE 9 18 ''MAT ST'SOX 168 -50 1 MPANY MA '0�1:48 501� compANY A CENTRAL TNS CE NTRAL C =,OANY INSURED 6MPANY ONSTRUCTION IN C P.-BEkiY-d" co INC CALDWELL''FARM LLC COMPANY 460-RObtON ST-STE #5,-- c TOPSFIELD MA 01983 * . . . . . . . . . . . . . ................. ..... . . . . . THIS IS To CER '168 OF INSURANCE LISTED BELOW. HAVE BEEN ISEWED TO THE INSURED �mrm ABOVE ICY PERIOD TIFy THAT THE POLIC N OF ANY CONTRACT 014 OTHER DOCUMENT WITH RESPECT TO WHICH THIS miCATED, NOTWITHSTANONG ANY REQUIREMEK, TERM OR CONDITIO ESCn 131 ALL THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES 0 IBED HEAM IS SU ECT TO TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BIEEN FIEDUCED, BY PAID CLAIMS. POUCY 11IFFICTIVE POUCY EXPIPATIOM UMITS or weURANCE - 00L= NUMBER DATE (MWDWM 13ATE MMUMT) LTR — CLP7916678 112/31/08 12/31/09 W-NEFWAIWIRFOATE s2,000,000 GENDIALLIABILIlly :. . 000,000 PF=UCn - Complop Aoo s2 o cOMMUCIX 6ENtRAL LtAkrry r;-Yn , , . . : ..:. . PERSONAL& ADY INJURY 1 _j CLAIMS MAM I AI ... ........ ... . .. -CACHO=UpRENM---.4--.- $I _00 D. RRkDAMQE-(A",0"w MEO M (Anr.0;V AUTOMOBILE UABil4T.Y. 12M INI!b3!N 7j: Al .. ...... .... AWICONECIAVtOG GOI3Ly'INJUFIy X SCHEDULED AUT9r, 130OLY INJURY s (PwacckWM NON4�11VNEOW;M PA0PERTYDAMA0E s AILITO ONLV - FA A=13ENt- "0 GARAG9 UANUTY O`I�WR 7HAN AUTO ONLY! AGCnCCAlV k!X . C11186 LIABILRY CXS7916679 12/51/08 31/09 EACH OCCURMNCM S5,000,000 umi3iw� M!,: A . 000E,0,9 i5,000;0 't amc UMBRELLAFOW 12/3-1/0 12/31/09 Y-t3mumom-1 P mye u' L . . ..... . ......... 0010 .0,000 - INCL PLC� v. -.500 eL cisrwe- EE PM OWL I MSCPJPnCN OF OPPPATIONS&OCATIC :141CLESWECIAL ITEMS r SWUL6'ANT0F THE AibVE OtWRIBCD POLICIPS BE CANCELLED 09fm WE &I�RA`n,6N uArE, - mkfwap. THE issumr. COMPANY WILL ENDEAVOR IV MAIL ljl� RIM' marnm TO THE CERTIRCAT9 WOUlgh NAMED TO Wj LEFr, .'eIJf rl;IILUF� 46:Miw.iu6l Nalce SMALL IMPOU NO ORWINnom on LIABILITY .*F.-; MY. KIND 1'�Up':6"ik :'rOMPh0V,'fM -AdZM OR AMRSENTAlum I AUTH0141WO REPRESENTATIVE; 7_M LIPPOPb- n`-`CPCU FM A jU $14 EN rA WD Cd ui am CD ca C.3 CL CD ca CD U3 = E 'cc E CD CD CD CL CO2 C,* co E.S CO3 CO "ff CIO co cm ti I'D CL coD.S E c.) 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