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HomeMy WebLinkAboutBuilding Permit #824-2016 - 53 SUTTON PLACE 1/20/2016Permit No#: -ul Date Issued: 1 �/4 I Vit► BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received ' IMPORTANT: Applicant must complete all items on this page LOCATION r Pring PROPERTY OWNER_ MAP Q_PARCE V'S,�L�o ib= NC Print 100 Year Structure ye no �lJ V ZONING DISTRICT: Historic District es no Machine Shop Village y s no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ane family ❑ Addition ❑ Two or more family ❑ Industrial t Alteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other L hSeptc ❑;Well❑'FI'©©d _. - Iain®�Weflands, - 4, wT �;Wateh edM}Distnct:, ,�O�W§titer/Sewers a DESCRIPTION OF WORK TO, BE PERFORMED: -XPlegse Type or Print, Clearly OWNER: Name: Address: e: Supervisor's Construction License:AGS�1:5:?q Exp. Date: di r Home Improvement License: ARCHITECT/ENGINEER =xp. Date: 4. r� Phone: Address: Reg. No FEE SCHEDULE: BULDING PERMIT: $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. Total Project Cost: $ (00 FEE: $ -36- Check No.: Receipt No.:e7A°vv NOTE: Persons co tracting with unregistered contractors do not have access to the guaranty fund V IF f Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ E 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 PLANNING & DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION - - Reviewed on__ _ .__ __. __ ____-_._ _ Signature_ COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Plpnning Board Decision: Comments r" 1 �_onservation Decision: Comments Water & Sewer Connection/signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street --............. 'ice � ✓' Fire Depa SRO signs:lure/date Dimension Number of Stories: Total land area, sq. ft.: Total square feet of floor area, based on Exterior dimensions. ELECTRICAL: Movement of Dieter 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 Ll Notified for pickup Call Ema Date Time Contact Name Doc.Building Permit 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 4� Copy of Contract 4� Floor Plan Or Proposed Interior Work 4. Engineering Affidavits for Engineered products TOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4. Building Permit Application iL Certified Surveyed Plot Plan 4. Workers Comp Affidavit _Photo Copy of H.I.C. And.C.S.L. Licenses. Copy Of Contract 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 TE: 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 4, Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products TE: 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 2014 Location AL ► Date 1 �7CAI TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 2% Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ! 4 r= 0 E , tlJ x w U Oz Oc m C N Y 'p O LL ?O -Z ❑. N O a. Z Z m O m C 3 LL bA 3 OC A U f0 LL O H z z m c D d b0 3 _ t0 LL O N z Q J LU tw 3 W U (n _ N LL cc a CA z N Q by .3. CC _ LL �- z cr Q w C LU LU LL m O z N N l% o Y O In o • i � o� OL co C Q: M F+ do c. N EQ. CD y CD c w E _ _O _ PM O (D v N Cc E J L' W CL �+ T C d O N N w CD cm�• C 'O > O,delt y y Q C O ... 0 .0 L-00 - y c c m o w .N 3 c Co 00 :r (D •� CL m 'Ca 5 `o A.- - Cl) 0) r- 0 _ O Q a`� ca o I— o w � m a> «, W O co 'O O O r.- LULl. !R N C O .N .Q r • O Z 1- N O +-� �- u 'E V-0 O V O W ` 0 W.— L H cn Q' d '> J y M O O H . CL o V > Z m coZ LLJ w/ w W IL ui J m Fil w N W L a� O v a CA 0 V ca Iml ma Ht mo O CL C. �a M J O CD Z V CL 1)11,3 0 2 0 Federal ID 1$ PdSE Engineering RI Contractor Registration No 7 MA Contractor Registration No A division of Thietsch Engineering CT Contractor Registration No 60 Shawmut Unit X2, Canton, MA 02021 CONTRACT 339-502-6335 rAX 339-502-6345 R S E PROGRAM Page 1 IS TH S CONTRACT IS ENTERED WTO BETWEEN RISE CMA -HES ENOINEERM AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW .. . ....... . ... ... ........ I ........... . . .. . ............. ... . . ....... ... .. ... . ..... . ......... ........ ... ... .... .. .. . ........ CUSTOMER PHONE DATE CLIENT 9 ........... . . WORK ORDER Dorothy Dibenedetto (781)789-2709 07/131220 15 408444 00002 1-1 ..... . .. . . .............. . ... . ....... . . . . . .... . ................ ... ............. . ..... - .... . ....... .... .. . . . . ............. . .. ..... . .............. SERVICE STREET SILLING STREET 53 Sutton Place 53 Sutton Place 'S"T' A -m- Z'W'' . . . ....... . . . ......... ... ....... . ... . ...... ...... SILLING CITY. STATE, ZW ... . North Andover, MA 0 1845 North Andover, MA 01845 . . . ........... . ..... . . .......... .................... . .................. ...... ........ . ....... .................................. . .. . ............. - ... ... .... ... ...... . .. ... ..... . . ............ . . . . . ..... JOB DE SCRIPTION - AIR SEALING: Provide labor and materials to seal areas ol'your home apinst wasteful, excess air leakage. This work will be performed in concert with the use ofspeciall tools and diagnostic tests lo�ssure that your home will be left with a healthful level of air exchange and indoor air quality. Materials to be used to seal your home can include caulks, foams and Other products. Primary areas for scaling include air leakage to attics, basements, attached garages and'other unheated areas (window-, are not generally addressed,) This will require (8) working hours. A reduction in cubic feet per minute (cfm) of air infiltration will occur, but the actual number of cim is not guaranteed. At the completion of the weatherization work, and at no additional cost to the homeowner. a final blower door and/or combustion safety analysis will be conducted by the sub -contractor to ensure the safety ofthe indoor air quality $680.00 AIR SEALING ADDER� (2) working hours. $170.00 ATTIC FLAT: Provide labor and materials to install an 8" layer of R-28 Class I Cellulose added to (900) square feet of open attic space, $1,233.00 STORAGE BARRIER� Homeowner is responsible for the removal of the stored items blocking the installation of weatherization work in the attic. Removal must occur prior to the scheduled work start. $0.00 VEN17LATION: Provide labor and materials to install ventils(ion chutes in (22) rafter ba�s to maintain air flow. S44,00 BASEMENT CEILING: Provide labor and materials to install (I (A) linear feet of R-19 unfaccd fiberglass insulation to the perimeter of the basement ceiling at the house sill. $287.00 RISE Engineering will apply all applicable. eligible incentives to this contract. You will only be billed the Net amount. Currently, for eligible measures. Colwnbia Gas offers 75% incentive, not to exceed $2,000 per calendar year, and an incentive of 1001/6 ror the Air Sealing mmsures; up to the first S680 and an additional $340 if savings are juitified by the auditor. For the safety and health of your home's indoor air quality, we will he conducting a blowcr door diagnostic of the available air flow in your home both before the work is begun, and after the wcatherization work is complete. We will also conduct a full assessment of the combustion salety of your heating system and water heater. This has a value of $90 and is at no cost to you, Total allowable wcathcrization incentive is $3,110. 7 S90.00 0 Federal ID # RISE Engineering RI Contractor Registration No IMA Contractor Registration No A division orThicisch Engineering CT Contractor Registration No 60 ShSwMUt Unit #2. Canton. MA 02021 CE3 A ONTFNPICT 339-502-6335 FAX 339-502-6345 R I S E PROGRAM Page 2 THIS CONTRACT IS ENTERED INTO BETWEEN ME ENCINEERINC CMA -HES ENGINE DESCRIBESERING AND THE CUSTOMER FOR WORK AS BELOW ­...",, ............................. ........... ........... 1-.1......_,.._.._.._.... .... .. ..... ................... ... CUSTOMER PHONE DATE CLIENT V WORK ORDER Dorothy Dibenedetto (781)789-2709 07113/2015 408444 00002 - — — ___- - - -­ - . ....... ......... .. . . ........ .. . ......... ............... ....... ........... . ....... ...... Total: $2,504.00 Program Incentive: $2,113.00 Customer Total: $391.00 WE AGREE HEREBY TO FURNISH SERVICES -COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS. FOR THE SUM OF ***Three Hundred Ninety -One & 001100 Dollars $391.00 APPROVAL By RISE ENSINEERM. CUSTOMER AORM TO REMIT AMOUNT DUE I" FULL INTEREST OF 1% WILL 69 CHARCED MONTHLY 04 ANY ON 00 NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES P7 -7 1 1 NOTE; THIS CONT.L." .1 WITHDRAWN BY US If NOT EXECUTED WITHIN DATE OF ACCEPTANCE ............ 30 ACCEPTANCE OFCONTRACT PRICES, , SPECIFICATION$ AND CONDITIONS ARE DAYS. SATISFACTORY TO US AND ARE HERESY ACCEPTED. YOU ARE AUTHORIZED TO 00 THE WORK AS SPECtRED. PAYMENT WILL BE MADE AS OUTLINED ABOVE The Commonwealth of Massachusetts Print Form 4 Department of Industrial Accidents - Office of Investigations 1 Congress Street, Suite 100 ' Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Builders Services Group d/b/a Quality Insulation Address: 110 Perimeter Rd City/State/Zip: Nashua NH 03063 Phone #: 603-324-1974 Are you an employer? Check the appropriate box: 1.0 1 am a employer with 100 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.+ required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t ❑ We area corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions I I. F] Plumbing repairs or additions 12.❑ Roof repairs 13.❑✓ Other Weatherization *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their' workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ACE American insurance Company Policy # or Self -ins. Lic. #: WLRC 48151553 Expiration Date: 6/30/2016 Job Site Address:�City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. 603-324-1974 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: A� oRo CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) I DM4,2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Aon RISk Services Central, Inc. Southfield MI office I CONTACT PHONE FAX (AIC. No. Ext): 1866) 283 7122 (AIC. No.): (800) 363-0105 E-MAIL ADDRESS: 3000 Town Center Suite 3000 - Southfield MI 48075 USA MWZY304$ 4 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A Old Republic Insurance Company 24147 TODBUild Coro. INSURER B: ACE American Insurance Company 22667 260 Jimmy Ann Drive Daytona Beach FL 32114 USA INSURER C: ACE Fire Underwriters Insurance Co. 20702 INSURER D: INSURER E: DAMAGE To RENTED PREMISES (Ea occurrence$2,000,000 INSURER F: COVERAGES CERTIFICATE NUMBER: 570058348882 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested LTR TYPE OF INSURANCE _ INSD WVD POLICY NUMBER IMMIDDM'YY MMIODNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY MWZY304$ 4 EACH OCCURRENCE $2,000,000 CLAIMS -MAGE ❑X OCCUR DAMAGE To RENTED PREMISES (Ea occurrence$2,000,000 MED EXP (Any one person) $25,000 PERSONAL B ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S4,000,000 X POLICY❑ JE O- ❑ LOC PRODUCTS - COMPIOP AGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY MwTB 304835 06/30/2015 06/30/2016 COMBINED SINGLE LIMIT $5,000,000 Ea accident BODILY INJURY ( Per person) ANY AUTO BODILY INJURY (Per accident) ALL OWNED SCHEDULED AUTOS AUTOS JX HIREDAUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident UABRELLA LIAR OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAR CLAIMS -MADE DED RETENTION ' B C WORKERS EMPLOYERS' COMPENSTA,fTION AND ANY PROPRIETOR l PARTNER EXECUTIVE YIN OFFICERIMEM13EREXCLUDED7 a NIA WLRC48151553 All Other States SCFC4815190 06/30/2015 06/30/2015 06/30/2016 06/30/2016 X STATUTE ORH E.L.EACHAccIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 (Mandatory in NH) WI Only If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT S1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Coverage CERTIFICATE HOLDER CANCELLATION ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Builder Services Group, Inc. AUTHORIZED REPRESENTATIVE A TopBUild Company 260 Jimmy Ann Drive Daytona Beach FL 32114 USA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD Office of Consumer Aitairs sand Business Reguiatior� 10 park Plaza -Suite 5170, Boston., Massachusetts 02116 Horne Improvement Contractor Registration BUILDER SERVICES GROUP, INC RICHARD SCHWARTZ 110 PERIMETER RD NASH UA, NH 03063 . r i r.... ,irr•r. Of,ice of Con sumer Affairs A Business Reg uintion t:'F_`} rJtdiE IMPROVEMENT CONTRACTOR 'r 2gi5i2Yi�P.: i7�14i Type Expiration: 6i[512016 Supplement .:crd )ILDER SERVICES GROUP; INC SHARD SCi-WARTZ 0 JIMTAY ANN DR!VE .YTONA SEACH. 71- 3211_4 Vnderst:crttary Registration:: 179141 Type: Supplement Card Expiration: 6125/2016 Undate Address and return card. Mark reason for change. Addrrsti Ren—AaI Ernploymert Iasi C'.:rd License or registration valid for individui ust: unl� before the expiration date. if found return to: Of%ct t;f Consumer Affairs and Business Regulation Ip P',H,' P!az2 - 5u?te 5170 Keston. MA 02116 tiot viii-&;K'ithout signature to BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received 2 /v',—neo �6f6N0\ of 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 r�r+ qq, < .1' "k _. Sepfic 1N,ell,� s 6Kl i •{. g, f! Floodplain VVetland :'e.. :i. ,•{4§+k Til�i'� _ 'X''�✓r.�.' WatershedfD+st WO— �k,– F�; r � ,�v VUaterlS ewer ..... ....... .v� r.i.-....� . -r.—.. �. «+ r ..._.+t-._�..».,,....._+..:•,.-,�. i'�+. ...F... _or.,��..w.•t- FAL L •,4 .,.�.4 a+l'1'X.. •.G''t!S_S'�rf'1 ,`�Rt-,a•,s �-�i" ^` DESCRIPTION OF WORK TO BE PREFORMED: or Print Clearly) OWNER: Name: Address: Phone CO'NTRRACPhone';-Y ., :''k r� x"; � • G.-vr'P'. _ 'e"?y �,� � }w" ""'^'"'" �`.."r.S�+""�e ,'.y'�`."'* t"�, �'n" ,""s t.' "" "y a f ; °v+"...Rh _"� • ; 1S Address ,l . i- ► • .,. .:.w. :.ate.. ss. wAa i� -�-.L #A� .: ..r. Aa.a `. a;. Su erviso"r s ConstructionQLicense' "- r � .=p `' Expo +®atehi +e- : i'�' _ Y 1'F+ -� ,s- .�.^,..�.• �X t w+. f * r rr 3 � � �+. ♦ i.Y' a 3�,o s �, m 3;_�+.+; w Ss� s -t F�' •.gy'as t At i�r`F'ti;+. t +.. •R �Home,ImprovementLicense ._,.x ':._. �'�. .� xp 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. W Total Project Cost: $ 3t am �— FEE: Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund 8— f67 Agent/Owner •K r. ". _,: g ture of contractor;... 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 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS_ [-\ \ HEALTH COMMENTS Reviewed on Signature DZ)" 1�3 � -2 l ly/) a - S CCry'\V-\A1 . owe' Reviewed on Signature ham - 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: 1 ,4 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 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 ❑ 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 ❑ Floor/Crossection/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 ❑ 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: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 n MORTGAGE INSPECTION PLAN NORTHERN ASSOCIATES, INC. 401 SOUTH BROADWAY, LAWRENCE MA. 01843-3522 TEL:(978) 837-3335 FAX:(978) 837-3336 MORTGAGOR: ALAN T * DOROTHY K DIDENEDETTO DEED REF: .I G97/0� LOCATION: 53 5UTTON PLACE PLAN REF: 5709 CITY,5TATE: N. ANDOVER, MA SCALE: 1 "=30' DATE: 3/19/10 JOB #: 2 10.00019 Ge, 40' TAKING DY TOWN OF NORTH ANDOVER 5K 1 14 PG I I i E.N.D.R.D. DETERMINED 13Y FIELD SURVEY JUNE, 1983 • • LOT 9 ?,5,-800 S.F. 1 5UTTON PLACE CERTIFIED TO:.RIVERDANK, I75 SUCCESSORS AND/ OR A551GN5 Flood hazard zone has been determined by scale and is not necessarily accurate.Untii definitive plans are issued by HUD and/or a vertical control survey is perjbrmed, precise elevations cannot be determined. NOTEI: This mortgage Inspection was prepared This mortgage inspection was prepared in accordance specifically jbr mortgage purpose only and with the Technical Standards jbr Mortgage Loan � is not to be relied upon as a land or property Inspections as adopted by the Massachusetts Board of line survey, used for recording, preparing deed Registration of Professional Engineers and land descriptions, or construction. No corners were set. Buildsnngg location and offsets are S 250 CMR 605. � 301 appromirnately located on and state that in my prolbstioral opinion that he the local horizontal ground J structures shown conform with zoning are shown specifically fbr zoning determination a �- m dimensional setback requirements at the time of construction or only and ars not to be used to establish property arc exempt under previsions of MAL CH. I0—A Sec. 7. liras. The matters shown hereon arc based on 8 client— }�r�► fished information and may be subject @P f. Pnperty/Nouse is not in Flood Hazard. to fwther out—sales, takings, easements and rights O 2, property/Nouse is in a Float Hazard Area of way, and other matters of record and pnrserptive 3 C:3 3. Iafbrmation is insujf tcent to determine Flood Nazar& or other rights. Northern Associates. Inc. assumes no 4/� �. S responsibility herein to land owner or occupant. �V Flood Hazard determined ffom latest Federal Flood accepts no responsibility jbr damages resulting from said reliaroa by anyone other than the said mortgages and its assigns Insum"ce hate Map Panel in connection with its sed mortgage financing to said mortgagor. j( 'y�i1Sl�/ffOC� J sexes �e � Zona ."��.2 . 7 .`.+� f /G Cra r�� S� , �o . f ----- ------ 00 tow Ae > Quail Run o 0, 4 O onteiro Way N pi A 7 rn Et ie pa CNrvyc E_ .i Town of North Andover Page 1 of 1 1 Select ........ , f (show all) :..:....: _...... _.......__. .. OwnerI Prop_ID Address DIBENEDETTO, ALAN T 060.0-0108-0000.0 53 SUTTON PLA( r 1 selected To Mailing Labels To Spreadsheet Print Ownerl DIBENEDETTO, ALAN T. Owner2 DIBENEDETTO, DOROTHY K. Address 53 SUTTON PLACE PropertyID 060.0-0108-0000.0 Lot Size 28749.6S Fiscal Year 2010 Land Use 101 Code r z`" tte+tin�v�eyr�rma�g.Caavet�naoes minaaYe ,y srcP+aararttl+, e>'p�sea a acme, rot esss�rre any �' L�tlatY srres�nns4rity the re� aa-uracY•cm4t=�. t. y,«�.+�,.�ad Bre C,engr 7c LnnmatA++Sy n+f�=}�+au+nvp�+era#a prori t ,. Mf 4-..0 Wes net take"DUced a pursgmna swy--yamnmm *og-mgma—shme ^x .bca7otLaa�5dC44 a9° r t�t<;re. p+ap 'Y iaan mP�tical �t2llai. A+snunac[s YeCy Carr an rcWr..sPs v �anY u�ot m�tta�nDeared trya RlafenCe bRssolixe atq ttl=F�fYl18cA W&tt>Umdng Crmnt:satsce.ezta�tnma�rov�rrdesm Ra9p'IS zsn N� aLG' .IYa:yO9 sEiC tbatmaita'� MYy use d tlxs iYpm�n kxi � f�}f1fS'sOwn �- http://mimap.mvpc.org/NorthAndovermimapNiewer.aspx 7/13/2012